Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Advance Care Planning: Preliminary Report of Differences and Similarities between Korean and Korean American

  • Received : 2013.06.18
  • Accepted : 2013.10.29
  • Published : 2013.12.01
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Abstract

Purpose: This study was conducted to do preliminary report of differences and similarities between Koreans residing in Korea and Korean Americans residing in America regarding their awareness of end-of-life care, attitudes toward advance care planning, truth telling, and preferred decision-making model. Methods: Two participating groups were selected: a) Koreans residing in Korea, and b) Koreans Americans who had resided in the United States for at least 20 years. 25 Koreans and 23 Korean Americans who were older than 65 years old participated in this study. They were asked via a self-administered questionnaire that contained demographic questions and questions about end-of-life decision making regarding awareness of end-of-life care, attitudes toward advance care planning, truth telling, and preferred decision-making model. A Chi-square was used to measure differences between Koreans' and Korean Americans planning. A P value of less than 0.5 was considered significant. Data analysis was performed using SPSS 18.0. Results: In some aspects of awareness of end of life care, attitudes toward advance care planning, and truth telling, both groups had similar opinions. However, there were significant differences between groups in the necessity of end of life documentation, preferential informing the truth, and preferred decision making model. Conclusion: There were similarities and differences regarding some end of life issues between the Koreans and the Korean Americans.

목적: 한국에 있는 한국 사람들과 미국에서 사는 재미 교포들간의 삶의 마지막 치료에 대한 의식, 삶의 마지막 전 계획에 대한 태도, 진실을 직면하는 태도 그리고 마지막 치료에 대한 결정을 누가 내리기를 원하는지에 대한 다른 관점들에 대해 밝히고자 한 예비 연구논문이다. 방법: 65세 이상의 한국에 사는 한국인들 25명, 미국에서 20년 이상 사신 한국인들 23명이 선택되었고 이들은 자신 개인신상에 대해 묻는 질문지와 임종에 가까워질 때 원하는 치료, 임종 전에 사전 계획을 세우는 것에 대한 것, 고칠 수 없는 자신의 병에 대한 진실을 대한 태도, 그리고 누가 마지막 치료에 대한 결정을 내리기를 원하는 지에 대한 질문지에 답하게 되었다. ${\chi}^2$ test로 한국인들 대상자들과 재미 교포 대상자들의 다른 점을 측정하는데 사용하였고, P value가 0.05보다 작은 것을 유용한 자료로 사용하였다. 자료 분석을 위해서는 SPSS 18.0을 사용하였다. 결과: 삶의 마지막 돌봄의 인식, 돌봄계획에 대한 태도, 그리고 진실 알리기 등의 항목에서는 한국인과 재미 교포간에 비슷한 의견을 보였다. 하지만, 삶의 마지막 돌봄에 대한 문서화, 진실을 누구에게 먼저 알릴 것인지, 그리고 선호하는 의사결정모델에서는 유의한 차이를 보였다. 결론: 한국인과 재미교포 사이에는 몇 가지 삶의 마지막 이슈에 대해 공통점과 차이점이 있었다.

Keywords

References

  1. Akabayashi A, Slingsby BT, Kai I. Perspectives on advance directives in Japanese society: A population-based questionnaire survey. BMC Med Ethics 2003;4:E5. https://doi.org/10.1186/1472-6939-4-5
  2. Bito S, Matsumura S, Singer MK, Meredith LS, Fukuhara S, Wenger NS. Acculturation and end-of-life decision making: comparison of Japanese and Japanese-American focus groups. Bioethics 2007;21:251-62. https://doi.org/10.1111/j.1467-8519.2007.00551.x
  3. Matsumura S, Bito S, Liu H, Kahn K, Fukuhara S, Kagawa-Singer M, et al. Acculturation of attitudes toward end-of-life care: a cross-cultural survey of Japanese Americans and Japanese. J Gen Intern Med 2002;17:531-9. https://doi.org/10.1046/j.1525-1497.2002.10734.x
  4. Ersek M, Kagawa-Singer M, Barnes D, Blackhall L, Koenig BA. Multicultural considerations in the use of advance directives. Oncol Nurs Forum 1998;25:1683-90.
  5. Colclough YY, Young HM. Decision making at end of life among Japanese American families. J Fam Nurs 2007;13:201-25. https://doi.org/10.1177/1074840707300761
  6. Murphy ST, Palmer JM, Azen S, Frank G, Michel V, Blackhall LJ. Ethnicity and advance care directives. J Law Med Ethics 1996;24:108-17. https://doi.org/10.1111/j.1748-720X.1996.tb01843.x
  7. Kwak J, Haley WE. Current research findings on end-of-life decision making among racially or ethnically diverse groups. Gerontologist 2005;45:634-41. https://doi.org/10.1093/geront/45.5.634
  8. Barnes JS, Bennett CE, U.S. Census Bureau. The Asian population, 2000. Washington, DC: U.S. Dept. of Commerce, Economics and Statistics Administration, U.S. Census Bureau; 2002.
  9. U.S. Census Bureau. American fact finder: Selected population profile in the United States, Korean alone or in any combination. Washington, DC: Washington, DC; 2007.
  10. Smets T, Rietjens JA, Chambaere K, Coene G, Deschepper R, Pasman HR, et al. Sex-based differences in end-of-life decision making in Flanders, Belgium. Med Care 2012;50:815-20. https://doi.org/10.1097/MLR.0b013e3182551747
  11. Blackhall LJ, Frank G, Murphy ST, Michel V, Palmer JM, Azen SP. Ethnicity and attitudes towards life sustaining technology. Soc Sci Med 1999;48:1779-89. https://doi.org/10.1016/S0277-9536(99)00077-5
  12. Sun DS, Chun YJ, Lee JH, Gil SH, Shim BY, Lee OK, et al. Recognition of advance directives by advanced cancer patients and medical doctors in hospice care ward. Korean J Hosp Palliat Care 2009;12:20-6.
  13. Heo DS. Patient autonomy and advance directives in Korea. J Korean Med Assoc 2009;52:865-70. https://doi.org/10.5124/jkma.2009.52.9.865
  14. Frank G, Blackhall LJ, Michel V, Murphy ST, Azen SP, Park K. A discourse of relationships in bioethics: patient autonomy and end-of-life decision making among elderly Korean Americans. Med Anthropol Q 1998;12:403-23. https://doi.org/10.1525/maq.1998.12.4.403
  15. Galambos CM. Preserving end-of-life autonomy: the Patient Self-Determination Act and the Uniform Health Care Decisions Act. Health Soc Work 1998;23:275-81. https://doi.org/10.1093/hsw/23.4.275
  16. Cohen-Mansfield J, Rabinovich BA, Lipson S, Fein A, Gerber B, Weisman S, et al. The decision to execute a durable power of attorney for health care and preferences regarding the utilization of life-sustaining treatments in nursing home residents. Arch Intern Med 1991;151:289-94. https://doi.org/10.1001/archinte.1991.00400020053012
  17. High DM. Why are elderly people not using advance directives? 1993;5:497-515. https://doi.org/10.1177/089826439300500405
  18. Blackhall LJ, Murphy ST, Frank G, Michel V, Azen S. Ethnicity and attitudes toward patient autonomy. JAMA 1995;274:820-5. https://doi.org/10.1001/jama.1995.03530100060035
  19. Kwon YC, Shin DW, Lee JH, Heo DS, Hong YS, Kim SY, et al. Impact of perception of socioeconomic burden on advocacy for patient autonomy in end-of-life decision making: a study of societal attitudes. Palliat Med 2009;23:87-94. https://doi.org/10.1177/0269216308099244
  20. Kagawa-Singer M, Blackhall LJ. Negotiating cross-cultural issues at the end of life: "You got to go where he lives". JAMA 2001;286:2993-3001. https://doi.org/10.1001/jama.286.23.2993