Korean J Fam Pract. 2018; 8(4): 634-638  https://doi.org/10.21215/kjfp.2018.8.4.634
Clinical Characteristics of Ward Hospice Patients and Home Hospice Patients
Deag-Yoon Choi, Seock-Hwan Lee*, Hyun-Seock Bae, Cheol-Woo Park
Department of Family Medicine, Daegu Medical Center, Daegu, Korea
Seock-Hwan Lee Tel: +82-53-560-7392, Fax: +82-53-560-7499 E-mail: fmdsky@hanmail.net ORCID: http://orcid.org/0000-0002-0638-643X
Received: May 4, 2017; Revised: August 21, 2017; Accepted: August 28, 2017; Published online: August 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Korea has been conducting a family hospice pilot project since 2016. The present study compared the characteristics of home hospice and ward hospice patients from the clinical aspect of pain and daily life performance, and from the familial, social, and economic aspects.
Methods: From March 2016 to December 2016, a total of 117 cancer patients in a metropolitan city hospital, whose treatment was terminated (died), was included in a ward hospice and a home hospice group. Initial Coordination ability, measured by the Eastern Cooperative Oncology Group scale, and the initial pain intensity and that 7 days from pain control, measured by the Numeric Rating Scale, were recorded. Familial assessment and economic assessment were also conducted.
Results: The initial pain intensity was higher in the home hospice group, whereas the pain intensity 7 days from pain control was higher in the ward hospice group. There was no significant difference between the two groups in the family assessment and the economic assessment. Most patients in both groups were not insured and did not have economic support.
Conclusion: The pain intensity in terminal cancer patients was not adequately controlled at home. All home hospice patients were finially enter to the ward hospice program. Initial home hospice patients pain intensity were high due to inadequate pain control. Furthermore, patients with terminal cancer and their families should be willing to attempt social rehabilitation of the patient and to bear the economic burden of improving the patient’s quality of life.
Keywords: Hospice; Hospital-Based; Neoplasm; Pain Management; Family Care; Family Medicine
References
  1. National cancer registry statistics [Internet]. Goyang: National Cancer Information Center [cited 2017 Jan 17].
    Available from: www.cancer.go.kr
  2. Cancer occurrence and death status [Internet]. Daejeon: Statistics Korea [updated 2017 Jan 19; cited 2017 Apr 15].
    Available from: http://www.index.go.kr
  3. Hwang SS, Chang VT, Alejandro Y, Osenenko P, Davis C, Cogswell J, et al. Caregiver unmet needs, burden, and satisfaction in symptomatic advanced cancer patients at a Veterans Affairs (VA) medical center. Palliat Support Care 2003; 1: 319-29.
    Pubmed CrossRef
  4. Schubart JR, Kinzie MB, Farace E. Caring for the brain tumor patient: family caregiver burden and unmet needs. Neuro Oncol 2008; 10: 61-72.
    Pubmed KoreaMed CrossRef
  5. Shin WJ, Hwang SW, Hwang IC, Choi YS, Lee YJ, Kim YS, et al. Unmet medical service needs in family caregivers of terminal cancer patients. Korean J Hosp Palliat Care 2016; 19: 163-9.
    CrossRef
  6. Statics of palliative care center of terminal cancer patients [Internet]. Goyang:Hospice and Palliative care [cited 2017 Apr 20].
  7. Hong YS. Withdrawal of life prolonging treatment, and palliative care. J Korean Med Assoc 2012; 12: 1188-92.
    CrossRef
  8. Kim BH, Park H. Comparison in spiritual well-being and quality of life between hospital and home hospice patients. J Korean Acad Community Health Nurs 2013; 24: 292-301.
    CrossRef
  9. Han KH, Jung JG, Oh SK, Kim JS, Kim SS, Kim SY. Depression level among family caregivers of terminal cancer patients. J Korean Acad Fam Med 2005;26: 752-8.
  10. Hospice care in America: National Hospice and Palliative Care Organization 2012 Facts and figures [Internet]. Virginia: National Hospice and Palliative Care Organization [cited 2017 Apr 1].
    Available from: https://www.nhpco.org/
  11. Lee KS, Joo JS, Kim JH, Kim KY. Current status and challenge of hospiceㆍ palliative care in Korea. Korean J Hosp Palliat Care 2008; 11: 196-205.
  12. Kim HS, June KJ, Son YS. Home-based hospice care provided by a freestanding hospice center: patients’ characteristics and service conditions. Korean J Hosp Palliat Care 2016; 19: 145-53.
    CrossRef
  13. Home-based hospice, Ambulatory medical health insurance number pilot project guidelines [Internet]. Wonju: Health Insurance Review and Evaluation Center [cited 2017 Apr 17].
    Available from: http://www.hira.or.kr
  14. Caraceni A, Cherny N, Fainsinger R, Kaasa S, Poulain P, Radbruch L, et al. Pain measurement tools and methods in clinical research in palliative care:recommendations of an Expert Working Group of the European Association of Palliative Care. J Pain Symptom Manage 2002; 23: 239-55.
    CrossRef
  15. Moon DH, Choe WS, Lee MA, Woo IS, Kang JH, Hong YS, et al. Clinical considerations about terminally ill cancer patients who died in hospice unit. Korean J Med 2004; 67: 341-8.
  16. Gidwani R, Joyce N, Kinosian B, Faricy-Anderson K, Levy C, Miller SC, et al. Gap between recommendations and practice of palliative care and hospice in cancer patients. J Palliat Med 2016; 19: 957-63.
    Pubmed CrossRef
  17. Sung E, Song MY, Jung SP, Byun JK, Park KT, Oh TG, et al. The narcotic analgesics in terminal cancer patients during the last 1 week to death. Korean J Fam Pract 2015; 5(Suppl 3): S732-7.
  18. Yun YH, Rhee YS, Nam SY, Park SM, Lee JS, Park MH, et al. The socioeconomic impact of terminal cancer on patients’ families and its associated factors. J Korean Acad Fam Med 2005; 26: 31-9.
  19. Lee TW, Lee WH, Kim MS. Comparison of the costs of care and nursing services for terminally Ill patients receiving home hospice care in comparison to institutional care. J Korean Acad Nurs 2000; 30: 1045-54.
    CrossRef
  20. Yong JS. Analysis of major complaints, reasons for referring home hospice, and nursing diagnosis of home hospice patients. J Res Inst Hosp Palliat Care 2005; 9: 8-17.


This Article

e-submission

Archives