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Kim J, Shin SJ, Yoon J, Kim HS, Lee JW, Kim YS, Kim Y, You HS, Kang HT. Recent trends in opioid consumption in Korea from 2002 to 2015, based on the Korean NHIS-NSC cohort. Epidemiol Health 2022; 44:e2022029. [PMID: 35209705 PMCID: PMC9117092 DOI: 10.4178/epih.e2022029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/21/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives Opioids are prescribed to treat moderate-to-severe pain. We aimed to investigate the recent trends in opioid (morphine, oxycodone, fentanyl, and hydromorphone) consumption using data from the Korean National Health Insurance Service-National Sample Cohort between 2002 and 2015. Methods Morphine milligram equivalent (MME) was calculated to standardize the relative potency of the opioids. The number (cases) or amount (MME) of annual opioid prescription per 10,000 registrants was computed to analyze trends of consumption of opioids after age standardization. Joinpoint regression analysis was conducted to calculate the annual percentage change and average annual percentage change (AAPC). Results The number (cases) of prescriptions per 10,000 registrants increased from 0.07 in 2002 to 41.23 in 2015 (AAPC [95% CIs], 76.0% [61.6-91.7%]). The MME per 10,000 registrants increased from 15.06 in 2002 to 40,727.80 in 2015 (AAPC [95% CIs], 103.0% [78.2-131.3%]). The highest AAPC of prescriptions and MME per 10,000 registrants were observed in the elderly (60-69 years) and at general hospitals. Fentanyl prescription increased most rapidly among four opioids. Conclusion Consumption of opioids greatly increased in South Korea over 14 years.
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Affiliation(s)
- Joungyoun Kim
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - Sang-Jun Shin
- Department of Information & Statistics, Chungbuk National University, Cheongju, Korea
| | - Jihyun Yoon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University, Yongin, Korea
| | - Hyeong-Seop Kim
- Clinical Trials Center, Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Jae-Woo Lee
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Ye-Seul Kim
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Yongwhan Kim
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Hyo-Sun You
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Hee-Taik Kang
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea.,Chungbuk National University College of Medicine, Cheongju, Korea, Cheongju, Korea
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Kang J, Choi EK, Seo M, Ahn GS, Park HY, Hong J, Kim MS, Keam B, Park HY. Care for critically and terminally ill patients and moral distress of physicians and nurses in tertiary hospitals in South Korea: A qualitative study. PLoS One 2021; 16:e0260343. [PMID: 34914723 PMCID: PMC8675648 DOI: 10.1371/journal.pone.0260343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/08/2021] [Indexed: 11/30/2022] Open
Abstract
Physicians and nurses working in acute care settings, such as tertiary hospitals, are involved in various stages of critical and terminal care, ranging from diagnosis of life-threatening diseases to care for the dying. It is well known that critical and terminal care causes moral distress to healthcare professionals. This study aimed to explore moral distress in critical and terminal care in acute hospital settings by analyzing the experiences of physicians and nurses from various departments. Semi-structured in-depth interviews were conducted in two tertiary hospitals in South Korea. The collected data were analyzed using grounded theory. A total of 22 physicians and nurses who had experienced moral difficulties regarding critical and terminal care were recruited via purposive maximum variation sampling, and 21 reported moral distress. The following points were what participants believed to be right for the patients: minimizing meaningless interventions during the terminal stage, letting patients know of their poor prognosis, saving lives, offering palliative care, and providing care with compassion. However, family dominance, hierarchy, the clinical culture of avoiding the discussion of death, lack of support for the surviving patients, and intensive workload challenged what the participants were pursuing and frustrated them. As a result, the participants experienced stress, lack of enthusiasm, guilt, depression, and skepticism. This study revealed that healthcare professionals working in tertiary hospitals in South Korea experienced moral distress when taking care of critically and terminally ill patients, in similar ways to the medical staff working in other settings. On the other hand, the present study uniquely identified that the aspects of saving lives and the necessity of palliative care were reported as those valued by healthcare professionals. This study contributes to the literature by adding data collected from two tertiary hospitals in South Korea.
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Affiliation(s)
- Jiyeon Kang
- Department of Anthropology, Seoul National University, Gwanak-gu, Seoul, Republic of Korea
| | - Eun Kyung Choi
- Medical Education Center, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Minjeong Seo
- College of Nursing and Gerontological Health Research Center in Institute of Health Sciences, Gyeongsang National University, Jinju, Gyeongsangnamdo, Republic of Korea
| | - Grace S. Ahn
- School of Medicine, University of California San Diego, La Jolla, CA, United States of America
| | - Hye Youn Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jinui Hong
- Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
| | - Min Sun Kim
- Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
- Department of Pediatrics, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
| | - Bhumsuk Keam
- Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
| | - Hye Yoon Park
- Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University, College of Medicine, Jongno-gu, Seoul, Republic of Korea
- * E-mail:
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Affiliation(s)
- Chang Gon Kim
- Graduate School of Social Welfare, Gwangju University, Gwangju, Korea
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Affiliation(s)
- Chang Gon Kim
- Graduate School of Social Welfare, Gwangju University, Gwangju, Korea
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Affiliation(s)
- Hyun Sook Kim
- Department of Social Welfare, Korea National University of Transportation, Chungju, Korea
| | - Young Seon Hong
- The Catholic University of Korea, School of Medicine, Seoul, Korea
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An AR, Lee JK, Yun YH, Heo DS. Terminal cancer patients' and their primary caregivers' attitudes toward hospice/palliative care and their effects on actual utilization: A prospective cohort study. Palliat Med 2014; 28:976-985. [PMID: 24781817 DOI: 10.1177/0269216314531312] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Previous studies on hospice/palliative care indicated that patients' socio-demographic factors, disease status, and availability of health-care resources were associated with hospice/palliative care utilization. However, the impact of family caregivers on hospice/palliative care utilization has not been thoroughly investigated. AIM To evaluate the association between attitudes toward hospice/palliative care of both patients with terminal cancer (defined as progressive, advanced cancer in which the patient will die within months) and their family caregivers and utilization of inpatient hospice/palliative care facilities. DESIGN A prospective observational cohort study was performed in 12 hospitals in South Korea. Attitude toward hospice/palliative care was assessed immediately after terminal cancer diagnosis. After the patient's death, caregivers were interviewed whether they utilized hospice/palliative care facilities. PARTICIPANTS A total of 359 patient-caregiver dyads completed baseline questionnaires. After the patients' death, 257 caregivers were interviewed. RESULTS At the baseline questionnaire, 137/359 (38.2%) patients and 185/359 (51.5%) of caregivers preferred hospice/palliative care. Preference for hospice/palliative care was associated with awareness of terminal status among both patients (adjusted odds ratio: 1.87, 95% confidence interval: 1.16-3.03) and caregivers (adjusted odds ratio: 2.14, 95% confidence interval: 1.20-3.81). Religion, metastasis, and poor performance status were also independently associated with patient preference for hospice/palliative care. At the post-bereavement interview, 104/257 (40.5%) caregivers responded that they utilized hospice/palliative care facilities. Caregiver's preferences for hospice/palliative care were significantly associated with actual utilization (adjusted odds ratio: 2.67, 95% confidence interval: 1.53-4.67). No patient-related factors were associated with hospice/palliative care utilization. CONCLUSION Promoting awareness of prognosis and to improve communication between doctors and families is important for facilitating the use of hospice/palliative care.
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Affiliation(s)
- Ah Reum An
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - June-Koo Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Young Ho Yun
- Department of Medicine, Seoul National University College of Medicine, Seoul, Korea Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Dae Seog Heo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea Department of Medicine, Seoul National University College of Medicine, Seoul, Korea Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Hong SJ, Lee E. Korean hospice nursing interventions using the Nursing Interventions Classification system: a comparison with the USA. Nurs Health Sci 2014; 16:434-41. [PMID: 24636239 DOI: 10.1111/nhs.12120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 11/13/2013] [Accepted: 11/24/2013] [Indexed: 11/26/2022]
Abstract
In this study, nursing interventions used by hospice nurses in Korea were identified and compared with core interventions selected by US end-of-life care nurses in order to determine similarities and differences between the two nations regarding such care. Data were collected from the electronic medical records of 353 hospice patients admitted to a tertiary hospital in Korea over a period of two years. First, extracted narrative interventions were mapped onto the Nursing Interventions Classification for comparison with interventions selected by nurses in the USA. A total of 56,712 intervention statements were mapped onto 147 Nursing Interventions Classification interventions. Hospice nurses in Korea performed more nursing interventions in the physiological basic domain, compared to nurses in the USA. The most frequently-used interventions in Korea were related to patient pain management. Among 47 core Nursing Interventions Classification interventions used in the USA, only 18 were used by Korean nurses in this study. This study highlights cultural differences in hospice care nursing interventions between the two countries.
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Affiliation(s)
- Sung-Jung Hong
- Department of Nursing, Semyung University, Jecheon, Korea
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Affiliation(s)
- Chai-Soon Park
- College of Nursing, The Catholic University of Korea, Seoul, Korea
| | | | - Yun Jung
- Department of Nursing, Kyungdong University, Wonju, Korea
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Kwak SY, Lee BS. Experience in Acceptance of Hospice by Patients with Terminal Cancer : A Phenomenological Research. J Korean Acad Nurs 2013; 43:781-90. [DOI: 10.4040/jkan.2013.43.6.781] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Su Young Kwak
- Dongsan Medical Center, Keimyung University, Daegu, Korea
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Affiliation(s)
- Chang-Gon Kim
- School of Social Welfare, Gwangju University, Gwangju, Korea
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