Cancer Research and Treatment

Original Articles

Changes of End of Life Practices for Cancer Patients and Their Association with Hospice Palliative Care Referral over 2009-2014: A Single Institution Study: Hyun Jung Jho, Eun Jung Nam, Il Won Shin, Sun Young Kim; Cancer Res Treat. 2020;52(2):419-425. Published online September 3, 2019; DOI: https://doi.org/10.4143/crt.2018.648

Purpose
In Korea, hospice palliative care (HPC) provision for cancer patients has increased recently. However, whether end of life (EoL) care practices have improved along with the development of HPC is unclear. We intended to investigate the changes in EoL care practices and their association with HPC referral. Materials and Methods Retrospective medical record review of adult cancer patients who died at National Cancer Center Korea from 1 January 2009 to 31 December 2014 was performed. Changes of EoL practices including chemotherapy within 2 weeks from death, death in intensive care unit (ICU), documentation of “do not resuscitate (DNR)” within 7 days from death and referral to HPC from 2009 to 2014 were analyzed as well as the association between referral to HPC and other practices.
Results
A total of 2,377 cases were included in the analysis. Between 2009 and 2014, referral to HPC increased and DNR documentation within 7 days from death decreased significantly. Cases for chemotherapy within 2 weeks from death and death in ICU didn’t change over the study period. Patients referred to HPC were less likely to receive chemotherapy within 2 weeks from death, die in ICU and document DNR within 7 days from death. Conclusion During the study period, EoL practices among cancer patients partly changed toward less aggressive in our institution. HPC referral was associated with less aggressive cancer care at the EoL. Policies to promote EoL discussion are necessary to improve the EoL practices of cancer patients.

Citations

Citations to this article as recorded by

Decreased aggressive care at the end of life among advanced cancer patients in the Republic of Korea: a nationwide study from 2012 to 2018
Sara Kwon, Kyuwoong Kim, Bohyun Park, So-Jung Park, Hyun Jung Jho, Jin Young Choi
BMC Palliative Care.2024;[Epub] CrossRef
Symptom burden, palliative care knowledge, and palliative care needs in advanced gynecological cancer patients in Korea
Eungil Ko, Yaelim Lee
Supportive Care in Cancer.2024;[Epub] CrossRef
End-of-Life Decision Making in Patients with Advanced Dementia: The Perspectives of the Korean General Population and Clinicians
So Yeon Jeon, Shin Hye Yoo, Jung Lee, In Gyu Song, Min Sun Kim, Hye Yoon Park
Psychiatry Investigation.2024; 21(10): 1137. CrossRef
Advance Care Planning in South Korea
Yu Jung Kim, Sun-Hyun Kim
Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen.2023; 180: 68. CrossRef
Public awareness of advance care planning and hospice palliative care: a nationwide cross-sectional study in Korea
Boram Kim, Junyong Lee, Youn Seon Choi
BMC Palliative Care.2023;[Epub] CrossRef
Prevalence and related factors of do-not-resuscitate orders among in-hospital cardiac arrest patients
Tangxing Jiang, Yanyan Ma, Jiaqi Zheng, Chunyi Wang, Kai Cheng, Chuanbao Li, Feng Xu, Yuguo Chen
Heart & Lung.2022; 51: 9. CrossRef
Discussing POLST-facilitated hospice care enrollment in patients with terminal cancer
Ho Jung An, Hyun Jeong Jeon, Sang Hoon Chun, Hyun Ae Jung, Hee Kyung Ahn, Kyung Hee Lee, Min-ho Kim, Ju Hee Kim, Jaekyung Cheon, Su-Jin Koh
Supportive Care in Cancer.2022; 30(9): 7431. CrossRef
A National Study of Life-Sustaining Treatments in South Korea: What Factors Affect Decision-Making?
So-Youn Park, Bomyee Lee, Jeong Yeon Seon, In-Hwan Oh
Cancer Research and Treatment.2021; 53(2): 593. CrossRef
Difficulties Doctors Experience during Life-Sustaining Treatment Discussion after Enactment of the Life-Sustaining Treatment Decisions Act: A Cross-Sectional Study
Shin Hye Yoo, Wonho Choi, Yejin Kim, Min Sun Kim, Hye Yoon Park, Bhumsuk Keam, Dae Seog Heo
Cancer Research and Treatment.2021; 53(2): 584. CrossRef
Changes in decision-making process for life-sustaining treatment in patients with advanced cancer after the life-sustaining treatment decisions-making act
Hyeyeong Kim, Hyeon-Su Im, Kyong Og Lee, Young Joo Min, Jae-Cheol Jo, Yunsuk Choi, Yoo Jin Lee, Daseul Kang, Changyoung Kim, Su-Jin Koh, Jaekyung Cheon
BMC Palliative Care.2021;[Epub] CrossRef
Consent for withholding life-sustaining treatment in cancer patients: a retrospective comparative analysis before and after the enforcement of the Life Extension Medical Decision law
Yu Jin Chung, Incheol Park, Junho Cho, Jin Ho Beom, Ji Eun Lee
BMC Medical Ethics.2021;[Epub] CrossRef
Implication of the Life-Sustaining Treatment Decisions Act on End-of-Life Care for Korean Terminal Patients
Jung Sun Kim, Shin Hye Yoo, Wonho Choi, Yejin Kim, Jinui Hong, Min Sun Kim, Hye Yoon Park, Bhumsuk Keam, Dae Seog Heo
Cancer Research and Treatment.2020; 52(3): 917. CrossRef

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Do Korean Doctors Think a Palliative Consultation Team Would Be Helpful to Their Terminal Cancer Patients?: Hye-Young Shim, Yoon Jung Chang, Kiu-Sang Kawk, Tran Thi Xuan Mai, Jin Young Choi, Eun Mi Ahn, Hyun Jung Jho, So-Jung Park; Cancer Res Treat. 2017;49(2):437-445. Published online August 10, 2016; DOI: https://doi.org/10.4143/crt.2015.495

Abstract PDF PubReader ePub

Purpose
Hospice and palliative care services (HPC) are not commonly utilized in Korea; however, palliative care teams (PCTs) have been found to be effective at addressing the shortcomings in HPC. In this study, we attempted to outline unmet palliative care needs of terminal cancer patients and the potential benefits of PCTs as perceived by doctors in Korea.
Materials and Methods
We surveyed 474 doctors at 10 cancer-related academic conferences from June to November 2014 with a self-report questionnaire to assess their perceptions of end-of-life care needs and the expected effects of PCTs on caring for terminal cancer patients. Among those surveyed, 440 respondents who completed the entire questionnaire were analyzed.
Results
In all domains, fewer participants reported satisfaction with palliative care services than those reporting needs (p < 0.001). The surveyed participants also reported difficulties with a shortage of time for treatment, psychological burden, lack of knowledge regarding hospice care, lengths of stay, and palliative ward availability. Multivariate logistic regression analysis revealed that female doctors (odds ratio [OR], 2.672; 95% confidence interval [CI], 1.035 to 6.892), doctors who agreed that referring my patients to a HPC means I must give up on my patient (OR, 3.075; 95% CI, 1.324 to 7.127), and doctors who had no experience with HPC education (OR, 3.337; 95% CI, 1.600 to 7.125) were associated with higher expected effectiveness of PCT activities.
Conclusion
The PCT activities were expected to fill the doctor’s perceived unmet HPC needs of terminal cancer patients and difficulties in communications.

Citations

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Effects of tertiary palliative care on the pattern of end‐of‐life care in patients with hematologic malignancies in Korea
Dong Hyun Kim, Jeonghwan Youk, Ja Min Byun, Youngil Koh, Junshik Hong, Tae Min Kim, Inho Kim, Sung‐Soo Yoon, Shin Hye Yoo, Dong‐Yeop Shin
European Journal of Haematology.2024; 112(5): 743. CrossRef
Development and validation of impact of early integration of palliative care and oncology(IEI PCO) questionnaire: a survey for medical oncologists and nurses
Abdulrahman Abdulaziz Abdullah, Wafaa Mostafa Abd-El-Gawad, Sobhi Mostafa AboSerea, Fatma AbdelShakor Ali, Saima Ali
BMC Palliative Care.2024;[Epub] CrossRef
Patients’ Dying Process From the Point of View of Family and Hospice Team: A Qualitative Exploration of Family Member and Hospice Team Experiences With Hospice in Korea
Sooyoun K. Han, Yugyeong Eo
OMEGA - Journal of Death and Dying.2022; 86(2): 533. CrossRef
Status of palliative care education in Mainland China: A systematic review
Antonia M. Willemsen, Stephen Mason, Silja Zhang, Frank Elsner
Palliative and Supportive Care.2021; 19(2): 235. CrossRef
Effectiveness of home hospice care: a nationwide prospective observational study
Eunmi Ahn, In Gyu Song, Jin Young Choi, Hyun Jung Jho, Ilyeon Park, Suah Sung, Seohyun Shin, So Jung Park, Eun Jung Nam, Sung Hoon Jeong, Yoon Jung Chang
Supportive Care in Cancer.2020; 28(6): 2713. CrossRef
Sedation for terminally ill cancer patients
Young Saing Kim, Haa-Na Song, Jin Seok Ahn, Su-Jin Koh, Jun Ho Ji, In Gyu Hwang, Jina Yun, Jung Hye Kwon, Jung Hun Kang
Medicine.2019; 98(5): e14278. CrossRef

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Terminal Versus Advanced Cancer: Do the General Population and Health Care Professionals Share a Common Language?: Sang Hyuck Kim, Dong Wook Shin, So Young Kim, Hyung Kook Yang, Eunjoo Nam, Hyun Jung Jho, Eunmi Ahn, Be Long Cho, Keeho Park, Jong-Hyock Park; Cancer Res Treat. 2016;48(2):759-767. Published online August 10, 2015; DOI: https://doi.org/10.4143/crt.2015.124

Abstract PDF PubReader ePub

Purpose
Many end-of-life care studies are based on the assumption that there is a shared definition of language concerning the stage of cancer. However, studies suggest that patients and their families often misperceive patients’ cancer stages and prognoses. Discrimination between advanced cancer and terminal cancer is important because the treatment goals are different. In this study, we evaluated the understanding of the definition of advanced versus terminal cancer of the general population and determined associated socio-demographic factors. Materials and Methods A total of 2,000 persons from the general population were systematically recruited. We used a clinical vignette of a hypothetical advanced breast cancer patient, but whose cancer was not considered terminal. After presenting the brief history of the case, we asked respondents to choose the correct cancer stage from a choice of early, advanced, terminal stage, and don’t know. Multinomial logistic regression analysis was performed to determine sociodemographic factors associated with the correct response, as defined in terms of medical context.
Results
Only 411 respondents (20.6%) chose “advanced,“ while most respondents (74.5%) chose “terminal stage” as the stage of the hypothetical patient, and a small proportion of respondents chose “early stage” (0.7%) or “don’t know” (4.4%). Multinomial logistic regression analysis found no consistent or strong predictor.
Conclusion
A large proportion of the general population could not differentiate advanced cancer from terminal cancer. Continuous effort is required in order to establish common and shared definitions of the different cancer stages and to increase understanding of cancer staging for the general population.

Citations

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Challenges and Proposed Improvements in Advance Care Planning: Insights from a Real Clinical Case of a Terminally Ill Patient in Korea
Hongyeul Lee
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