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Factors influencing Preferences for Care near the End-of-life among Undergraduate Nursing Students

간호대학생 임종치료선호도에 영향을 미치는 요인

  • Cheon, Jooyoung (Department of Nursing Science, Sungshin Women's University)
  • 천주영 (성신여자대학교 간호학과)
  • Received : 2020.11.03
  • Accepted : 2020.12.20
  • Published : 2020.12.28

Abstract

This study aimed to identify factors influencing the preferences for end-of-life (EOL) care among undergraduate nursing students. In this cross-sectional study, data were collected from December 2017 to February 2018. This study included 217 undergraduate nursing students. Factors influencing the preference for 'autonomous physiological decision-making' were the following: education level(by grade), having biomedical education, attitude towards death, and attitude towards life-sustaining treatments (LSTs). Preference for 'decision-making by healthcare professionals' was related to having a religion. Factors influencing the preference for 'spirituality' were education level, having a religion, and academic major satisfaction. Preference for 'pain control' was associated with education level, experience with dying patients, bad self-rated health, attitude towards death, and attitude towards LSTs. The study findings suggest that education regarding LSTs, EOL care, and EOL decision-making in nursing curricula is essential.

본 연구는 간호대학생들의 임종치료선호도에 영향을 미치는 요인을 확인하기 위해 수행되었다. 이 조사 연구는 2017년 12월부터 2018년 2월까지 수행되었으며, 최종 217명의 간호대학생의 자료가 수집되었다. '자율적 의사결정' 선호도에 영향을 미치는 요인은 교육수준(학년), 생명의료윤리 교육 수강, 죽음에 대한 태도, 연명치료에 대한 태도였다. '의료인의 의사결정'에 대한 선호도는 종교를 가지는 것과 관련이 있었다. '영성'에 대한 선호도에 영향을 미치는 요인은 교육수준(학년), 종교를 가짐, 전공만족도였다. '통증 조절'에 대한 선호도는 교육수준(학년), 사망한 환자 관찰경험, 나쁜 주관적 건강상태, 죽음에 대한 태도, 연명치료에 대한 태도와 관련이 있었다. 본 연구 결과는 간호학 전공 커리큘럼에서 연명치료, 생애말기간호 및 생애말기 의사결정에 관한 교육이 필수적임을 시사한다.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2017R1C1B5076398).

References

  1. K. Ahn & H. Bae. (2010). Reflections on the movement for the legalization of "death with dignity as withdrawal of futile life-sustaining treatment" in South Korea. Journal of Korean Law, 10(1), 43-64.
  2. M. Kim. (2018). The problems and the improvement plan of the hospice/palliative care and dying patient's decisions on life-sustaining treatment act. Korean Journal of Hospice and Palliative Care, 21(1), 1-8. DOI : 10.14475/kjhpc.2018.21.1.1
  3. J. Y. Choi, Y. J. Son & K. Lee. (2020). Attitudes, perceptions, and experiences toward end-of-life care decision-making among intensive care unit nurses in Korea: an integrative review. Journal of Korean Critical Care Nursing, 13(1), 27-43. DOI : 10.34250/jkccn.2020.13.1.27
  4. B. Miller. (2018). Nurses preparation for advanced directives: an integrative review. Journal of Professional Nursing, 34(5), 369-377. DOI : 10.1016/j.profnurs.2018.07.001
  5. S. J. Lee & H. Y. Kim. (2017). Attitude, role perception and nursing stress on life sustaining treatment among intensive care unit nurses. Korean Journal of Adult Nursing, 29(2), 131-142. DOI : 10.7475/kjan.2017.29.2.131
  6. J. Kang, S. Yun, S. J. Kim, S. R. An, M. H. Lee & S. Kim. (2013). Preferences for care near the end of life among hospital employees. Journal of Muscle and Joint Health, 20(3), 197-206. DOI : 10.5953/JMJH.2013.20.3.197
  7. G. M. Kim, K. S. Sung & E. J. Kim. (2017). Awareness of nursing students' biomedical ethics and attitudes toward withdrawal of life-sustaining treatment. Child Health Nursing Research, 23(3), 292-299. DOI : 10.4094/chnr.2017.23.3.292
  8. H. J. Lee, J. H. Ha & J. Yun. (2019). Nursing students' knowledge, attitudes to advance medical directives and ethics values. Journal of Korean Academy of Nursing Administration, 25(4), 282-291. DOI : 10.11111/jkana.2019.25.4.282
  9. M. Dimoula, G. Kotronoulas, S. Katsaragakis, M. Christou, S. Sgourou & E. Patiraki. (2019). Undergraduate nursing students' knowledge about palliative care and attitudes towards end-of-life care: a three-cohort, cross-sectional survey. Nurse Education Today, 74, 7-14. DOI : 10.1016/j.nedt.2018.11.025
  10. N. S. Jang, H. S. Park, M. R. Kim, J. Y. Lee, Y. W. Cho, K. M. Kim & Y. J. Son. (2018). Knowledge, confidence, and learning needs regarding advance directives among hospital nurses. Journal of Korean Critical Care Nursing, 11(1), 35-45.
  11. S. W. Hong & S. M. Kim. (2013). Knowledge regarding advance directives among community-dwelling elderly. Journal of Korean Academic Society of Nursing Education, 19(3), 330-340. DOI : 10.5977/jkasne.2013.19.3.330
  12. J. A. Thorson & F. C. Powell. (1988). Elements of death anxiety and meanings of death. Journal of Clinical Psychology, 44(5), 691-701. DOI : 10.1002/1097-4679(198809)44:5<691::AID-JCLP2270440505>3.0.CO;2-D
  13. S. C. Park. (1992). A study on the death orientation of hospice volunteers. Journal of Korean Academy of Nursing, 22(1), 68-80.
  14. J. H. Kim. (2006). Relationship between spiritual well-being and attitudes toward death in volunteers for hospice care. Master's thesis. Kosin University, Busan.
  15. G. S. Park. (2000). The study of consciousness of euthanasia among health professionals: Q-methodological approach. Doctoral dissertation. Dankook University, Cheonan.
  16. E. K. Byun, H. R. Choi, A. L. Choi, K. H. Hong, N. M. Kim & H. S. Kim. (2003). An investigative research on the attitudes of intensive care unit nurses and families on terminating life support. Clinical Nursing Research, 9(1), 112-124.
  17. Y. J. Lee & S. M. Kim. (2009). Validating the Korean version of the Preferences for Care near the End of Life(PCEOL-K) scale. Korean Journal of Medical Ethics, 12(1), 29-42. https://doi.org/10.35301/ksme.2009.12.1.29
  18. D. M. Gauthier & R. D. Froman. (2001). Preference for care near the end of life: scale development and validation. Research in Nursing & Health, 24(4), 298-306. DOI : 10.1002/nur.1031
  19. I. Jang & Y. Kim. (2019). Effects of awareness to well-dying, knowledge and attitudes toward advance-directives on attitude toward end-of-life care in nursing students. Korean Journal of Rehabilitation Nursing, 22(2), 104-113. DOI : 10.7587/kjrehn.2019.104
  20. E. J. Lee, K. H. Hwang & O. H. Cho. (2019). Subjective attitudes towards terminal patients of nursing student with clinical practice experience: application of Q methodology. Korean Journal of Hospice and Palliative Care, 22(4), 156-165. DOI : 10.14475/kjhpc.2019.22.4.156
  21. K. E. Kwon & M. S. Yoo. (2018). Biomedical ethics awareness and attitudes toward dignified death and advance directives among nursing students. Journal of Korean Academic Society of Home Health Care Nursing, 25(3), 204-214. DOI : 10.22705/jkashcn.2018.25.3.204
  22. M. M. Garrido, E. L. Idler, H. Leventhal & D. Carr. (2013). Pathways from religion to advance care planning: beliefs about control over length of life and end-of-life values. The Gerontologist, 53(5), 801-816. DOI : 10.1093/geront/gns128
  23. M. H. Lee & Y. H. Park. (2015). Factors influencing attitude toward advance directives of older cancer patients. Korean Journal of Adult Nursing, 27(4), 449-458. DOI : 10.7475/kjan.2015.27.4.449
  24. Y. N. Choi. & Y. S. Song. (2018). Life-sustaining treatment choices and related factors involving hospital nurses. Journal of Korean Public Health Nursing, 32(2), 167-180. DOI : 10.5932/JKPHN.2018.32.2.167
  25. A. L. Kim. (2019). Influencing factors on the elderly's preference in care near the end of life: focusing on preparation for death and anxiety for death. Journal of the Korean Society for Wellness, 14(1), 113-123. DOI : 10.21097/ksw.2019.02.14.1.113