성인간호학회지 (Korean Journal of Adult Nursing)

  • 제28권3호
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  • Pages.334-342
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  • 2016
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  • 1225-4886(pISSN)
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  • 2288-338X(eISSN)
한국성인간호학회 (Korean Society of Adult Nursing)
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지역사회거주 노인의 연명치료 중단에 대한 자기결정 영향 요인

Factors Influencing Self Determination for Withdrawing Life-Sustaining Treatment of the Community Dwelling Elderly

  • 김현숙 (삼육대학교 대학원 간호학과) ;
  • 장혜경 (구립신내노인종합복지관) ;
  • 신성례 (삼육대학교 간호학과)
  • 투고 : 2016.04.14
  • 심사 : 2016.06.22
  • 발행 : 2016.06.30
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초록

Purpose: This study was conducted to identify factors that influence on self-determination for withdrawal of life-sustaining treatment in the community dwelling elderly. Methods: This study used a descriptive correlational design. A convenience sample of 201 elderly were recruited from a welfare center located in Seoul, Korea. Data collection was done from September 1 to September 18, 2015. Four survey questionnaires were used: Multidimensional Scale of Perceived Social Support (MSPSS), Life Satisfaction Index-Z (LSI-Z), Attitude on Do Not Resuscitate (DNR), and Self-determination for Withdrawing Life-sustaining Treatment. Data analysis was done by t-test, ANOVA, Pearson's correlation, and hierrarchical multiple regression. Results: Hierarchial multiple regression showed that the factors predicting the level of self-determination for withdrawing life-sustaining treatment were educational level, DNR experience in family, life satisfaction, and DNR attitude. These factors explained 44% of the self-determination for withdrawing life-sustaining treatment in community dwelling elderly. Conclusion: The results of this study suggest developing educational programs aiming at changing elderly's DNR attitude positive ways so that they can enhance self-determination for withdrawing life-sustaining treatment. Further study is needed with more elderly population in extended areas.

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참고문헌

  1. Statistics Korea. Elderly statistics 2015 [Internet]. Daejeon: Ministry of Health & Welfare, Statistics Korea; 2015 [Cited 2016 June 19]. Available from: http://kostat.go.kr/portal/eng/pressReleases/1/index.board?bmode=read&aSeq=349205
  2. Korea Statistical Information Service. 2014 Senior survey: number of chronic diseases in the elderly (over 65 years). Seoul: Ministry of Health & Welfare, Korea Statistical Information Service; 2014 [Cited 2016 July 5]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_11771_2011N035&conn_path=I3
  3. Kim HR, Oh KS, Oh KO, Lee SO, Lee SO, Lee SJ, et al. Quality of life in low income Korean aged. Journal of Korean Academy of Nursing. 2008;38(5):694-703. http://dx.doi.org/10.4040/jkan.2008.38.5.694
  4. Choe JY, Kim HC. A patient’s right of self-determination for withdrawal of the life-sustaining treatment; court case review. Bioethices Policy. 2009;3(2):155-72.
  5. Jeun YJ. Right of informed concent and withdrawing of life-sustaining treatment. Law Review. 2009;33:455-76.
  6. Kim HS, Shin SR. The effect of educational program on withdrawing life-sustaining treatment for elderly. Journal of Korea Academia-Industrial Cooperation Society. 2015;16(1):397-407. http://dx.doi.org/10.5762/KAIS.2015.16.1.397
  7. Park YO. Experience of family members on deciding to withdraw life-sustaining treatment for patients who are terminally ill. Paper presented at: The meeting of Korean Society of Nursing Science; 2004 May; Seoul.
  8. Han NY, Yoon HJ, Park EW, Cheong YS, Yoo SM. Perception of a good death in the elderly. Korean Journal of Family Medicine. 2002;23(6):769-77.
  9. Kim KS. Application of advance directives at a general hospital [master's thesis]. Ulsan: University of Ulsan; 2010.
  10. Lee MH. The effects of ego integrity trait of elderly persons on life-sustaining treatment preferences. Journal of Digital Convergence. 2016;14(2):489-99. http://dx.doi.org/10.14400/JDC.2016.14.2.489
  11. Chang CY, Kim YS. Attitude toward forgoing life-sustaining treatment among cancer patient families. The Korean Academy of Mental Health Social Work. 2011;38:5-30.
  12. Carmel S, Mutran EJ. Stability of elderly persons' expressed preferences regarding the use of life-sustaining treatments. Journal of Social Science Medicine. 1999;49(3):303-11. http://dx.doi.org/10.1016/S0277-9536(99)00121-5
  13. Ko EJ, Lee JH. End-of-life treatment preference among low-income older adults: a race/ethnicity comparison study. Journal of Health Care for The Poor and Underserved. 2014;25(3):1021-33. https://doi.org/10.1353/hpu.2014.0129
  14. Kim ES. Perception and ethical attitude about withdrawing of life-sustaining treatments f or the elderly between elderly patients and their family. [master's thesis]. Jeonju: Chonbuk National University; 2012.
  15. Yoon MS, Kim JS. Factors to the withdrawing of life sustaining treatment among low income elderly. Korea Academy of Mental Health Social Work. 2015;43(3):192-219.
  16. Chung SD, Kim SH, Koo MJ. The relationship between death related factors and death preparation: a comparison of pre-elderly and babyboomers. Korea Journal of Population B Studies. 2014;37(1):131-53.
  17. Garrido MM, Balboni TA, Maciejewski PK, Bao Y, Prigerson HG. Quality of life and cost of care at the end of life: the role of advance directives. Journal of Pain and Symptom Management. 2015;49(5):828-35. http://dx.doi.org/10.1016/j.jpainsymman.2014.09.015
  18. Gerstel E1, Engelberg RA, Koepsell T, Curtis JR. Duration of withdrawal of life support in the intensive care unit and association with family satisfaction. American Journal of Respiratory and Critical Care Medicine. 2008;178(8):798-804. http://dx.doi.org/10.1164/rccm.200711-1617OC
  19. Kim YS. Attitude of death perception on hospice and attitudes of DNR by nursing students in an area. The Korean Journal of Health Service Management. 2014;8(3):219-28. http://dx.doi.org/10.12811/kshsm.2014.8.3.219
  20. Lee HK, Kang HS. Attitudes and awareness towards the withdrawal of life-sustaining treatment among nurses, physicians, and families of intensive care unit patients. Journal of Korean Clinical Nursing Research. 2010;16(3):85-98.
  21. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. Journal of Personality Assessment. 1988;52(1):30-41. http://dx.doi.org/10.1207/s15327752jpa5201_2
  22. Shin JS, Lee YB. The effects of social supports on psychosocial well-being of the unemployed. Korean Journal of Social Welfare. 1999;(37):241-69.
  23. Neugarten BL, Haighurst RJ, Tobin SS. The measurement of life satisfaction. Journal of Gerontology. 1961;6(1):134-43. http://dx.doi.org/10.1093/geronj/16.2.134
  24. Lee CE. A study on the relation ship between perception of sex life and life satisfaction in elderly [master's thesis]. Seoul: Hanyang University; 1999.
  25. Korean Medical Association, Korean Academy of Medical Sciences, Korean hospital association. Guidelines on withdrawing life-sustaining therapy. Seoul: Special Committee Established Guidelines on Withdrawing Life-Sustaining Therapy; 2009. p. 1-10.
  26. Lee YS, Ministry of Health & Welfare, Research Affairs of Seoul National University. Survey of the people's understanding on withdrawal of life-sustaining management and proposal of its legislation. Seoul: Ministry of Health & Welfare; 2009. 1-360.
  27. Fortner BV, Neimeyer RA. Death anxiety in older adults: a quantitative review. Death Studies. 1999;23(5):387-411. https://doi.org/10.1080/074811899200920
  28. Sun DS, Chun YJ, Lee JH, Gil SH, Shim B, Lee OK, et al. Recognition of advance directives by advanced cancer patients and medical doctors in hospice care ward. The Korean Journal of Hospice and Palliative Care. 2009;12(1):20-6.
  29. Bettinghaus EP, Cody MJ. Persuasive communication. 5th ed. NY: Wadswort Publishing; 1994. p. 432.
  30. Seo YS, Son YL, Sung KW. Factors related to the death attitudes among the elderly women in rural areas. Journal of Korean Gerontological Nursing. 2011;13(1):21-8.

피인용 문헌

  1. 간호사 자신과 간호사 가족의 연명의료 결정과 관련요인 vol.32, pp.2, 2016, https://doi.org/10.5932/jkphn.2018.32.2.167
  2. Influence of Older Person's Ego Integrity and Knowledge of Advance Directives on their Attitude toward Withdrawal from Life-sustaining Treatment vol.21, pp.3, 2019, https://doi.org/10.17079/jkgn.2019.21.3.173