Browse > Article
http://dx.doi.org/10.14475/kjhpc.2018.21.3.92

Factors Influencing Withdrawal of Life-Sustaining Treatment in Tertiary General Hospital Workers -Knowledge and Attitude of Organ Donation and Transplantation, Awareness of Death, Knowledge and Perception of Hospice Palliative Care-  

Je, Nam Joo (Department of Nursing, Changshin University)
Hwa, Jeong Seok (Department of Urology, Gyeongsang National University Hospital, College of Medicine and Institute of Health Sciences, Gyeongsang National University)
Publication Information
Journal of Hospice and Palliative Care / v.21, no.3, 2018 , pp. 92-103 More about this Journal
Abstract
Purpose: This descriptive study was conducted to examine factors that affect hospital workers in their decision to withdraw from life-sustaining treatment, such as knowledge, attitude, and perception of organ donation, transplantation, death and hospice palliative care. Methods: A questionnaire was completed by 228 workers of a tertiary general hospital, and data were analyzed using t-test, ANOVA, and Pearson's correlation by using SPSS 21.0. Results: The subjects' knowledge of biomedical ethics awareness differed by age, education level, occupation, affiliated department, and biomedical ethics education. Their knowledge of brain death, organ donation and transplantation was positively correlated with attitudes toward tissue donation and transplantation, knowledge of hospice palliative care, and perception of hospice palliative care. Their attitudes toward tissue donation and transplantation were significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care, and withdrawal of life-sustaining treatment. Their awareness of death was significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care and withdrawal of life-sustaining treatment. The perception of hospice palliative care was significantly correlated with withdrawal of life-sustaining treatment. Factors associated with their withdrawal of life-sustaining treatment were work at the hospice ward (32.5%), attitudes toward tissue donation and transplantation and perception of hospice palliative care. Conclusion: This study has shown that work at the hospice ward, attitudes toward tissue donation and transplantation and perception of hospice palliative care were related to attitudes toward withdrawal of life-sustaining treatment. More research is needed to further develop various curriculums based on biomedical methods.
Keywords
Bioethics; Death; Hospice care; Perception; Transplantation;
Citations & Related Records
Times Cited By KSCI : 7  (Citation Analysis)
연도 인용수 순위
1 Kim MO. Awareness of biomedical ethics of long-term care hospital nurses. JKAIS 2015;16:4048-55.
2 Jeon MK, Moon MY, Jaung AH. Relationship between nurses' consciousness of biomedical ethics, job satisfaction and nursing performance. J Korean Bioethics Assoc 2013;14:27-47.
3 Choi EJ, Jeong HS. The effect of nursing students' consciousness of biomedical ethics, good death recognition, and self-esteem on the attitude toward withdrawal of life-sustaining treatment. JKAIS 2018;19:275-84.
4 Kwon HJ. Hospital nurses' attitudes concerning human tissue donation and transplantation [master's thesis]. Seoul: Kyung Hee Univ.; 2009. Korean.
5 Lee JA, Kim SY. The knowledge and attitude of medical students towards the organ donation. J Korean Soc Transplant 2008;22:120-9.
6 Joo AE. Nurse's attitudes regarding organ transplantation [master's thesis]. Seoul: Yonsei Univ.; 1995. Korean.
7 Chong YR, Lee YH. Affecting factors of the awareness of biomedical ethics in nursing students. J Korean Acad Soc Nurs Educ 2017;23:389-97.
8 Kang HY. A study on nursing college students' knowledge and attitudes toward brain death, organ donation and organ transplantation. J Korean Acad Soc Nurs Educ 1999;5:7-19.
9 Kim JG. Current situations of legislation of decision making regarding life-sustaining treatments in Korea. Catholic Institute of Bioethics 2014;4:35-57.
10 Kim MJ, Park SY, Park SJ, Park JY, Lee YH, Choi EA. Comparative study of nursing students consciousness of biomedical ethics and attitudes toward human tissue donation and transplantation according to participation in anatomy camp program. Korean J Phys Anthropol 2017;30:99-107.   DOI
11 Lee JA. The knowledge and attitude of medical students towards the organ donation. [master's thesis]. Seoul: Public Health Yonsei Univ.; 2008. Korean.
12 Oh NS, Park JY, Han CH. Knowledge and attitude of university student' on brain death and organ donation. Korean Public Health Research 2006;32:85-93.
13 Park BI. Knowledge of organ donation and attitude toward brain death and organ donation [master's thesis]. Busan: Kosin Univ.; 2001. Korean.
14 Sung MH, Son EY, Lee SE. A study on knowledge and attitude of nurses regarding brain death organ donation. Clin Nurs Res 2006;12:125-35.
15 Yun MJ. A study on the consciousness of biomedical ethics, attitudes human tissue donation and transplantation. J Digital Convergence 2016;14:407-16.
16 Choi GH, Kwon SH. The effects of a hospice palliative education program on perception of hospice, attitude to death, and meaning of life in adults. Korean J Hosp Palliat Care 2018;21:14-22.   DOI
17 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.   DOI
18 Tsung PL, Lee YJ, Kim SY, Kim SK, Kim SA, Kim HJ. et al. Effects of death preparation education on awareness of hospice palliative care and withdrawing life sustaining treatment in city dwellers. Korean J Hosp Palliat Care 2015;18:227-34.   DOI
19 Kang DY, Shim HW. Attitude of elderly people on life support care-Q methodological approach-. JKCA 2015;15:355-69.
20 Joung SA, Park KY. The relationships between knowledge on advance directive, attitudes towards the withdrawal of life-sustaining treatment and quality of life in hemodialysis patients. J Korean Acad Community Health Nurs 2017;28:291-301.   DOI
21 Byun EK, Choi HR, Choi AL, Hong KH, Kim NM, Kim HS. An investigative research on the attitudes of intensive care unit nurses and families on terminating life support. J Korea Clin Nurs Res 2003;9:112-24.
22 Park KS. The study of consciousness of euthanasia among health professionals: Q-methodological approach [master's thesis]. Yongin: Dankook Univ.; 2000. Korean.
23 Kim YH, Yoo YS, Cho OH. Nursing students' awareness of biomedical ethics and attitudes toward death of terminal patients. Korean J Hosp Palliat Care 2013;16:1-9.   DOI
24 Han JY, Lee NY. Nursing students' attitude toward death and perception on hospice care. J Korean Oncol Nurs 2009;9:95-103.
25 Choi ES. Nurses' awareness of biomedical ethics and their attitude toward withdrawal of life-sustaining treatment [master's thesis]. Wonju: Gangneung-Wonju National Univ.; 2016. Korean.
26 Matten MR, Sliepcevich EM, Sarvela PD, Lacey EP, Woehlke PL, Richardson CE, et al. Nurse's knowledge, attitudes and beliefs regarding organ and tissue donation and transplantation. Public Health Rep 1991;106:155-66.
27 Kim TE. General people's attitudes regarding human tissue donation and transplantation [master's thesis]. Seoul: Yonsei Univ.; 2004. Korean.
28 Inumiya Y. A study on development of a view of life and death scale and relationships among its elements [dissertation]. Seoul: Korea Univ.; 2002. Korean.
29 Ross MM, McDonald B, McGuiness J. The palliative care quiz for nursing (PCQN): the development of an instrument to measure nurses' knowledge of palliative care. J Adv Nurs 1996;23:126-37.   DOI
30 Cha YR. A study on the nurses' attitude to death in Korea -centering on university hospital in Jeollabuckdo province- [master's thesis]. Iksan: Wonkwang Univ.; 2005. Korean.
31 Kim SH, Choi YS, Shin SW, Chong MK, Lee SN, Lee SW, et al. Development of education program for physicians based on the 2004 hospice palliative model project for terminal cancer. Korean J Hosp Palliat Care 2006;9:67-76.
32 Jang MY, Kim JY, Yang SK. Factors affecting on terminal care attitudes in nursing students. AJMAHS 2016;6:269-81.
33 Kim JH. The attitude of medical personnel about death and hospice research [master's thesis]. Seoul: Hanyang Univ.; 1990. Korean.
34 Lee EJ. A study of spot-survey towards the attitude of hospice [master's thesis]. Iksan: Wonkwang Univ.; 1998. Korean.
35 Kim MS. Comparison on the perception about hospice and the meaning of life of participants and non-participants of the hospice volunteer education program. Gwangju: Chonnam National Univ.; 2007. Korean.
36 Kim HC, Yoon ER. Implication and legal issues of revised human tissue act. Asia Pacific J Health Law & Ethics 2015;9:127-48.
37 Ko GH, Cho IS. Attitudes towards death and euthanasia among nurses and general population. J Korea Contents Assoc 2015;15:229-40.   DOI
38 Seo HA, Eom SJ, Kang HY. Effect of early childhood pre-service teachers' perception of death and happiness on their subjective well-being. J EECE 2015;14:279-302.
39 Cho YH, Factors affecting the consciousness of biomedical ethics of the nursing students before clinical practice in convergence era. J Korean Continence Soc 2017;8:359-69.
40 Kim SN, Kim HJ, Recognition of good death, attitude towards the withdrawal of life-sustaining treatment, and attitude towards euthanasia in nurses. Korean J Hosp Palliat Care 2016;19:136-44.   DOI
41 Ku YM. Biomedical ethics. 3rd ed. Paju:Dongnyok;2010. p. 48-50.
42 Kong BH, Gu YH, Kim SD, Kim JG, Um YR. Bioethics. 2nd ed. Seoul:Hyunmoon;2017.
43 Kim SH. Bioethics. Seoul:Philosophy and Reality;2008.
44 Lee KJ, Yoo SY. Relationships between nurses' ethical dilemma, coping types, job satisfaction and turnover intention in Korea. J Korea Clin Nurs Res 2011;17:1-15.
45 Statistics Korea. Preliminary results of birth and death statistics in 2017 [Internet]. Daejeon: Statistics Korea; 2018 [cited 2018 Feb 28]. Available from: http://kostat.go.kr/portal/korea/kor_nw/2/2/1/index.board?bmode=read&aSeq=366414.
46 Lee JW. The ethical problems on defining brain death and organ transplantation. J New Korean Philos Assoc 2012;69:271-95.
47 Kim JG, Oh SM, Cheon EY, Yoo JH. Factors influencing the attitude toward death in college nursing student. JKAIS 2016;17:676-83.
48 Olsen ML, Swetz KM, Mueller PS. Ethical decision making with end-of-life care: palliative sedation and withholding or withdrawing lifesustaining treatments. Mayo Clin Proc 2010;85:949-54.   DOI
49 Kim SN, Kim HJ. Recognition of good death, attitude towards the withdrawal of life-sustaining treatment, and attitude towards euthanasia in nurses. Korean J Hosp Palliat Care 2016;19:136-44.   DOI
50 Kwon YO, Ahn SH. The attitude and perception on withdrawal of futile life sustaining treatment and patient self determination right among home care nurses. J Korean Bioethics Assoc 2013;14:53-66.