Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
권호 표지
DOI QR코드

DOI QR Code

The Perceptions and Needs of Hospice Palliative Care and Shared Decision Making among Middle-Aged Adults

중년기 성인의 호스피스 완화의료와 공유의사결정에 대한 인식 및 요구도

  • 이나연 (계명대학교 간호대학) ;
  • 이승진 (분당서울대학교병원) ;
  • 이수경 (계명대학교 간호과학연구소)
  • Received : 2016.06.16
  • Accepted : 2016.11.19
  • Published : 2016.12.01
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study is to examine the level of understanding of hospice palliative care (HPC) and shared decision making (SDM) among middle-aged adults. Methods: Data were collected from 90 middle-aged adults living in D city using a self-reported questionnaire. The SPSS program was used to analyze the data. Results: Among the participants, 76.7% were aware of the HPC while 82.2% of the participants were not aware of SDM. Among all, 85.6% responded positively for needs of HPC, and 77.8% of participants for SDM. Participants with Christian faith (Protestants and Catholics), high income level and present illness were better aware of HPC than others. The most needed services were nursing care and treatment along with systematic counseling and explanation provided by the medical staff. There was also a significant relationship between the HPC factors, gender, income, current health status and current illness status. Participants with high income level were well aware of SDM. Stronger SDM needs were observed among participants with professional jobs or current illness. Conclusion: For continued discussion on HPC and SDM, it is necessary to implement and promote various education programs for medical staff and the public.

목적: 본 연구의 목적은 중년기 성인의 호스피스 완화의료와 공유의사결정에 대한 인식 및 요구도를 파악하는 것이다. 방법: 대상자는 D광역시에 거주하는 40세 이상 65세 미만의 중년기 성인 중 연구의 목적을 이해하고 동의한 90명이었다. 자료는 자가 보고식 설문지로 수집하였으며, SPSS/WIN 21.0 프로그램을 이용하여 분석하였다. 결과: 대상자 중 76.7%가 호스피스 완화의료에 대해 인식하였으나 공유의사결정에 대해서는 82.2%가 인식하지 못하였다. 대상자들은 호스피스 완화의료와 공유의사결정에 대하여 각각 85.6%, 77.8% 필요하다고 하였다. 호스피스 완화의료에 대한 인식은 기독교나 천주교인 경우, 소득이 높을 때, 현재 질병이 있을 때 인식률이 높았으며, 의료진의 체계적인 상담 및 설명을 들을 수 있는 간호 및 치료방법에 대한 요구도가 가장 높았다. 성별, 소득수준, 현재 건강상태 및 질병상태에 따라 치료결정 항목의 중요도에 차이가 있었다. 소득수준이 높을 때 공유의사결정에 대한 인식은 높았으며, 전문직업이 있거나 현재 질병이 있을 때 공유의사결정에 대한 요구도가 높았다. 결론: 향후 국내에서 호스피스 완화의료와 공유의사결정에 대한 논의가 지속적으로 진행되기 위해서는 의료진 및 일반인들을 대상으로 한 다양한 교육프로그램의 시행과 홍보가 필요하다.

Keywords

References

  1. Status of hospice and palliative care support project in 2014 [Internet]. Goyang: National Cancer Center; 2015. [updated 2015 Nov 18; cited 2016 Mar 14]. Available from: http://hospice.cancer.go.kr/hospice/front/boardView.do?keykind=&keyword=&page_now&returl=/hospice/front/boardList.do&listurl=/hospice/front/boardList.do&brd_mgrno=181&menu_no=442&brd_no=88011.
  2. Kim JA, Kim KH, Kang HS, Kim JS. Nursing need and satisfaction of patients in hospice ward. Korean J Hosp Palliat Care 2014;17:248-58. https://doi.org/10.14475/kjhpc.2014.17.4.248
  3. Kiho Ilbo: Take off the first step in 'Hospice and palliative care' [Internet]. Incheon: Kiho Ilbo; c2009 [cited 2016 Mar 21]. Available from: http://www.kihoilbo.co.kr/?mod=news&act=articleView&idxno=638232.
  4. Lee TW, Lee WH, Kim MS. Comparison of the casts of care and nursing services for terminally III patients receiving home hospice care in comparison to institutional care. J Korean Acad Nurs 2000;30:1045-54. https://doi.org/10.4040/jkan.2000.30.4.1045
  5. The Segye Times: Nine of ten people "Need hospiece care" [Internet]. Seoul: The Segye Times; c2015 [cited 2016 Mar 21]. Available from: http://www.segye.com/content/html/2015/11/26/20151126001184.html.
  6. Kim SH, Lee WH. An integrative review of do-not-resuscitate decisions in Korea. Korean J Med Ethics 2011;14:171-84.
  7. Ministry of Health & Welfare, National Cancer Center. Introduction of hospice and palliative care for palliative care team. 1st ed. Seoul, Goyang: Ministry of Health & Welfare, National Cancer Center; 2012.
  8. Lee EY. A study of patient decision aids (PtDAs) for shared decision making in medical decisions. Bioethics Policy Studies 2014;8:119-40.
  9. Edwards A, Elwyn G. Inside the black box of shared decision making: Distinguishing between the process of involvement and who makes the decision. Health Expect 2006;9:307-20. https://doi.org/10.1111/j.1369-7625.2006.00401.x
  10. Kim HS. Aspacts of shared decision making of the medical treatments for older cancer patients [dissertation]. Seoul: Chungang Univ.; 2009. Korean.
  11. Jo KH. Development and evaluation of shared medical decisionmaking scale for end-of-life patients in Korea. J Korean Acad Nurs 2012;42:453-65. https://doi.org/10.4040/jkan.2012.42.4.453
  12. Lee SH, Han HS, Chang CH, Park BK, Kim SS. Korean college students' attitudes and preferences toward shared decisionmaking between patients and physicians. Korean J Med Ethics 2012;15:52-69.
  13. Hong SW, Kim SM. Knowledge regarding advance directives among community-dwelling elderly. J Korean Acad Soc Nurs Educ 2013;19:330-40. https://doi.org/10.5977/jkasne.2013.19.3.330
  14. Yun SY, Kang JY. Preferences for care near the end of life according to chronic patients' characteristics. Korean J Adult Nurs 2013;25:207-18. https://doi.org/10.7475/kjan.2013.25.2.207
  15. Jo KH. Nurse's conflict experience toward end-of-life medical decision-making. Korean J Adult Nurs 2010;22:488-98.
  16. Lee JM, Kim JS. Study on nursing needs for hospice patients and their families. J Korean Acad Fundam Nurs 2000;7:287-300.
  17. Belanger E, Rodriguez C, Groleau D. Shared decision-making in palliative care: a systematic mixed studies review using narrative synthesis. Palliat Med 2011;25:242-61. https://doi.org/10.1177/0269216310389348
  18. Kang KA. Development and effects of death preparation education for middle-aged adults. Korean J Hosp Palliat Care 2011;14:204-11.
  19. Kim SM, Kim KS, Lee IS, Kim SY. Perception towards advance directives, hospice-palliative care, life-sustaining treatment among the middle aged adults. Korean J Soc Welf Res 2013;37:21-44.
  20. Park YS, Lee SO, Hong SA. A comparative study on death orientation and self-esteem between hospice volunteer experience and hospice volunteer non-experience of middle-aged women. Korean J Health Serv Manag 2012;6:35-44. https://doi.org/10.12811/kshsm.2012.6.2.035
  21. Shin KH. Relation between perception of good death and hospice among middle-aged members of local church [master's thesis]. Busan: Kosin Univ.; 2013. Korean.
  22. Han J, Lee N. Nursing students' attitude toward death and perception on hospice care. J Korean Oncol Nurs 2009;9:95-103.
  23. NCC: Development of tailored intervention program enhancing quality of life and quality of care in patients with cancer [Internet]. Goyang: National Cancer Center; 2009. [updated 2013 May 16; cited 2016 Jan 05]. Available from: http://report.ndsl.kr/repDetail.do?cn=TRKO201100006969.
  24. O'Connor AM, Llewellyn-Thomas HA, Flood AB. Modifying unwarranted variations in health care: shared decision making using patient decision aids. Health Aff (Millwood) 2004;Suppl Variation:VAR63-72.
  25. Brace C, Schmocker S, Huang H, Victor JC, McLeod RS, Kennedy ED. Physicians' awareness and attitudes toward decision aids for patients with cancer. J Clin Oncol 2010;28:2286-92. https://doi.org/10.1200/JCO.2009.25.2874
  26. Lee YE, Choi EJ, Park JS, Shin SH. Perception and knowledge of hospice care and attitude toward death held by medical professionals from the same region in Korea. Korean J Hosp Palliat Care 2013;16:242-52. https://doi.org/10.14475/kjhpc.2013.16.4.242
  27. Lee HJ. A study on the nursing student's attitude toward death and perception on hospice care. J East-West Nurs Res 2013;19:88-95. https://doi.org/10.14370/jewnr.2013.19.2.88
  28. Jung HO, Chung KT, Hwang WD, Kim YS, An JH, Kim DH, et al. A study on university students' orientation and attitudes on hospice-to develop homo humanitas thanatology. J North-East Asian Cult 2010;22:153-68.
  29. Son YJ, Park Y. Perception on hospice, attitudes toward death and needs of hospice care between the patients with cancer and family. Korean J Rehabil Nurs 2015;18:11-9. https://doi.org/10.7587/kjrehn.2015.11
  30. Ko SH, Kim HK. The knowledge and needs of hospice for inpatients' family. Korean J Hosp Palliat Care 2005;8:131-42.
  31. Moon DH, Lee MA, Koh SJ, Choi YS, Kim SH, Yeom CH. Doctor's attitudes toward hospice and palliative care for terminal cancer patients. Korean J Hosp Palliat Care 2006;9:93-100.
  32. Kim JH, Lim CH, Jung HR. A study about hospice perception of nursing university student. J Digital Convergence 2014;12:391-6.
  33. Jung JE. The comparison of the perceived nursing needs between hospitalized cancer patients, and nurses. J Korean Clin Nurs Res 2003;8:91-105.
  34. Song JI, Shin DW, Choi JY, Kang J, Baik YJ, Mo H, et al. Quality of life and mental health in family caregivers of patients with terminal cancer. Support Care Cancer 2011;19:1519-26. https://doi.org/10.1007/s00520-010-0977-8
  35. Ro YJ, Han SS, Ahn SH, Yong JS. Community residents' knowledge, attitude, and needs for hospice care. Korean J Hosp Palliat Care 1999;2:23-35.
  36. Suh YO. Health promoting lifestyle, hardiness and gender role characteristics in middel-aged women. Korean J Women Health Nurs 1996;2:119-34.
  37. Kim MS. Impact of shared decision making on patient's satisfaction in rheumatic disease [master's thesis]. Seoul: Hanyang Univ.; 2011. Korean.
  38. Institute of Medicine (U.S.). Committee on Quality of Health Care in America. Crossing the quality chasm : a new health system for the 21st century. Washington, DC:The National Academies Press;c2001.
  39. Kim MS. A study on the grade of the medics' recognition about the shared decision making and communication between outpatient and medics [master's thesis]. Seoul: Yonsei Univ.;2010. Korean.
  40. Dong-A Ilbo: Nurse Kim hyun-ah's properly know about the hospice] Do you know the right of patients? [Internet]. Seoul:Dong-A Ilbo; c2016 [cited 2016 Mar 21]. Available from:http://news.donga.com/3/all/20160307/76849822/1.
  41. Yoon YS, Kim MH, Park JH. Perception of shared decision making and conflict decision-making related to surgery in elderly patients with cancer. J Korean Gerontol Nurs 2014;16:266-75. https://doi.org/10.17079/jkgn.2014.16.3.266
  42. Arcuri L, Montagnini B, Calvi G, Goss C. The perception of shared medical decision making of expert and lay people: Effects of observing a movie clip depicting a medical consultation. Patient Educ Couns 2013;91:50-5. https://doi.org/10.1016/j.pec.2012.11.003

Cited by

  1. End-of-Life Care Attitudes Among Middle-Aged Koreans vol.19, pp.5, 2017, https://doi.org/10.1097/NJH.0000000000000372
  2. An exploratory study on the shared decision-making as a two-way symmetrical communication process : focusing on the communication of kidney dialysis patients vol.65, pp.2, 2016, https://doi.org/10.20879/kjjcs.2021.65.2.005