Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Development of a Korean Version of an Advance Directive Model via Cognitive Interview

인지면담을 이용한 한국형 사전의료의향서 모델 개발

  • Kim, Shin Mi (Department of Nursing, Changwon National University) ;
  • Hong, Young Sun (The Catholic University of Korea School of Medicine) ;
  • Hong, Sun Woo (Department of Emergency Medical Technology, Daejeon University) ;
  • Kim, Jin Shil (Department of Nursing, Suncheon National University) ;
  • Kim, Ki Sook (Department of Nursing, Changwon National University)
  • Received : 2012.11.22
  • Accepted : 2013.02.12
  • Published : 2013.03.01
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Abstract

Purpose: The purpose of the study was to develop a feasible form of a Korean version of advance directives (K-AD). Methods: Sixteen adults participated in this study: 10 aged 20~50 years and nine aged 65 years or older. Using a draft version of the K-AD, cognitive interview was conducted on the participants to establish a culturally acceptable form of advance directives whose directions can be understood and responded accordingly by the general population. Results: Cognitive interviews revealed areas of concerns for the draft version of K-AD: lack of instructions or clarity for technical and medical terms, context complexity and inadequate response categories. The draft version was revised by rewording, offering examples and rearranging the context. Editorial style was added with appropriate uses of bold fonts, bullet-points and underlines to facilitate interviewees' cognitive responses. Conclusion: Study results feasibility of the revised version of the K-AD. Further study should be performed with a larger number of participants to develop a K-AD with an acceptable level of reliability and validity.

목적: 본 연구의 목적은 사전의료의향서 사용 집단을 대상으로 초안에서 도출된 한국형 사전의료의향서 콘텐츠의 구성 요소를 바탕으로 실제 사용자 집단에서 인지적, 심리적 및 사회적으로 수용 가능한 문장과 문항으로 구성된 문서를 구축하여 한국형 사전의료의향서 모델을 제시하는 것이다. 방법: 실제 사용자인 일반 성인의 보건의료정보 문해력과 정서적 수용성 및 작성 과정을 고려하여 초안을 작성하였으며 초안을 바탕으로 인지면담(Cognitive Interviewing) 방법을 통한 문항 개발 과정을 수행하였다. 대상자는 9명의 65세 이상 노인을 포함한 16명의 인지면담에 장애가 없는 성인이었다. 결과: 총 2회기에 걸친 인지면담 결과를 분석한 후 최종적으로 3개 속성(가치관, 의료지시[9문항] 대리인 지정)을 중심으로 총 430개 단어로 구성되는 모델을 확정 제안하였다. 결론: 본 연구에서는 한국형 사전의료의향서 문서를 효과적으로 향상시킬 수 있는 방법으로 인지면담을 사용하였으며 그 가능성을 검증하였다. 한국형 사전의료의향서 최종 모델을 위해서는 대규모 양적 연구를 통해 가용성을 검증하며, 신뢰도와 타당도를 확보하여 모델을 확정하는 과정이 포함된 추후연구가 필요할 것이다.

Keywords

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