• Journal of the Korea Society of Computer and Information
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• v.25 no.5
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• pp.169-178
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• 2020

This study was attempted to know the awareness of Advance Directives of adults in Gandwon-do province. Data was surveyed from 60 adults in Gangwon-do province by 42 item questionnaire for the awareness of Advance Directives. Subcategories of Advanced Directives questionnaire were knowledge, preference, experience for life-sustaining treatment and Advance Directives. The data was analyzed with the frequency and percentage using SPSS 24.0. 45% of Participants replied they knew the 'life-sustaining treatment' exactly. They preferred CPR 78.3%, mechanical ventilation 63.3% and blood transfusion 51.7% for their future special life-sustaining treatments. They did not preferred hemodialysis 8.3%, artificial respiration 6.7%, intensive care unit 6.7%, 8.3 percent of participants said that they well aware of Advance Directives. 86.6% of them hoped to write their Advance Directives. Despite such low awareness of the Advance Directives, the intention to write Advance Directives was high. Based on these results, it was found that the level of awareness of Advance Directives was very important for the intention to prepare Advance Directives. Therefore, regional programs and education on Advance Directives and periodic survey study for awareness of Advance Directives should be continued.

• Journal of Korea Entertainment Industry Association
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• v.14 no.6
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• pp.181-190
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• 2020

The study was conducted to examine the correlations between nursing students' knowledge, attitudes to advance medical directives and hospice perception. Data were collected using questionnaires from 181 students who were in 2rd and 4th year of the nursing college in D city, from May to Jun 2019. The collected data was analyzed using descriptive statistics, pearson's corelation coefficient and stepwise multiple regression with IBM SPSS 21.0 program. The study results showed that university students in nursing scored 3.52±.69, points for knowledge of advance directives, 3.10±.36 for attitude of advance directives, 3.14±.27 for hospice perception. The knowledge for advance directives was positively correlated with Attitude (r=.38, p <.001), and toward perception for hospice (r=0.28, p <.001). Based on the results of this study, it is necessary to develop a systematic education program in order to improve the awareness of the Perception of Hospice, Knowledge and Attitude toward Advance Directives.

• The Journal of the Korea Contents Association
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• v.21 no.4
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• pp.688-698
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• 2021

The purpose of this study was to determine the effects of perception of good death and knowledge toward advance directive on attitude toward withdrawal of life-sustaining treatment among university hospital nurses. The subjects of this study were 207 university hospital nurses. Data were analyzed using the SPSS Statistics 24.0 version. The results showed that factors influencing attitude toward withdrawal of life-sustaining treatment were perception of good death (𝛽=-.32, p<.001), education experience for good death (𝛽=.15, p=.024), and knowledge toward advance directive (𝛽=.14, p=.036). They explained 14.2% of attitude toward withdrawal of life-sustaining treatment. Based on the results of this study, it suggests the development of education programs for good death and life-sustaining treatment to improve the perception of good death, knowledge toward advance directive of university hospital nurses.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.2
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• pp.539-547
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• 2021

This study was conducted to identify the effects of knowledge of Advance Directives (AD) and the patient's perception of a peaceful death on their attitude toward the withdrawal of life-sustaining treatment and to provide basic data for the development of a nursing intervention program for activating self-determination in the withdrawal of life-sustaining support of patients. The subjects were 167 adult cancer patients who received outpatient or inpatient treatment, from September 15, 2019, to March 30, 2020. The data was analyzed by mean, standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression by using SPSS 21.0. From the results, it was observed that the knowledge of AD was 8.87±2.46 out of 12, perception of a peaceful death was 2.87±0.42 out of 4, and attitude toward withdrawal of life-sustaining treatment was 3.46±0.49 out of 5. There was a positive correlation between knowledge of AD, perception of a peaceful death, and their attitude toward withdrawal of life-sustaining treatment. The influencing variables were the knowledge of AD, perception of a peaceful death, discussion with family on withdrawal of life-sustaining treatment, and explanation power was 16.0% (F=10.355, p<.001). Therefore, it is necessary to develop a program that would improve the perception of a peaceful death, increase the knowledge of AD to improve the patients' attitude toward the withdrawal of life-sustaining treatment. An intervention to assist a discussion between the patients and their families in advance would also be useful.

• Journal of Internet of Things and Convergence
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• v.6 no.1
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• pp.45-53
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• 2020

This study aimed to examine the relationship of the knowledge of end-of-life(EOL) care, life-sustaining treatment(LST), and advance directive(AD) with the educational needs regarding AD writing among nurses in convergence era. For this cross-sectional study, participants were 169 nurses at a general hospital in South Korea. Data were collected from July 19 to 26 in 2018 using structured questionnaires. Knowledge on EOL care scored 8.56 out of 11 points, knowledge on LST scored 5.11 out of 6 points, and knowledge on AD scored 8.02 out of 9 points. Educational needs regarding AD writing scored 4.31 out of 5 points. There were statistically correlations between knowledge on LST and educational needs regarding AD writing (r=.182, p=.018), and between knowledge on AD and educational needs regarding advance AD writing (r=.234, p=.002). The findings can be used to develop the educational program regarding AD.

• Journal of the Korean Applied Science and Technology
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• v.37 no.5
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• pp.1430-1440
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• 2020

The purpose of this study was to identify relationships between the awareness of well-dying, advance directives knowledge and attitude, according to patient's terminal care experience among nursing students. Participants were 321 nursing students, selected from 3 universities located in Gyeonggi-do, Chungcheong-do, Jeolla-do and data were collected using self-reported questionnaires. Data were analyzed using the SPSS/WIN 25.0 program, with descriptive statistics x²-test, t-test, ANOVA, Scheffe' test, Pearson's correlation coefficient. There was a significant difference in advance directives attitude among nursing students with experience of patient's terminal care or no experience of patient's terminal care (t=3.011, p<.003). In addition, the awareness of well-dying (r=.194, p=.008) and advance directives knowledge (r=.201, p=.006) were positively correlated with advance directives attitude in nursing students with experience of patient's terminal care, whereas advance directives attitude was positively correlated with the awareness of well-dying (r=.189, p=.029) in nursing students with no experience of patient's terminal care. This study suggests that there is a need for the development of systematic education programs to improve a positive attitude toward advance directives and awareness of well-dying of nursing college students.

• Journal of Hospice and Palliative Care
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• v.14 no.2
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• pp.91-100
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• 2011

Purpose: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. Methods: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) ${\geq}$10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. Results: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. Conclusion: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.103-128
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• 2023

According to the current act of Decision-Marking in Life-Sustaining Medicine, the decision to withhold or discontinue life-sustaining treatment is primarily based on the wishes of a patient in the dying process. Decision-making regarding life-sustaining treatment for these patients is made by the patient, if he or she is conscious, directly expressing his/her intention for life-sustaining treatment in writing or verbally or by writing an advance medical directive and physician orders for life-sustaining treatment. It can be exercised. On the other hand, if the patient has not written an advance medical directive or physician orders for life-sustaining treatment, the patient's intention can be confirmed with a statement from the patient's family, or a decision to discontinue life-sustaining treatment can be made with the consent of all members of the patient's family. However, in the case of an unrelated patient who has no family or whose family is unknown, if an advance medical directive or physician orders for life-sustaining treatment are not written before hospitalization and a medical condition prevents the patient from expressing his or her opinion, the patient's will cannot be known and the patient cannot be informed. A situation arises where a decision must be made as to whether to continue or discontinue life-sustaining treatment. This study reviewed discussions and measures for unbefriended patients under the current law in order to suggest policy measures for deciding on life-sustaining treatment in the case of unbefriended patients. First, we looked at the application of the adult guardian system, but although an adult guardian can replace consent for medical treatment that infringes on the body, permission from the family court is required in cases where death may occur as a direct result of medical treatment. It cannot be said to be an appropriate solution for patients in the process of dying. Second, in accordance with Article 14 of the Life-Sustaining Treatment Decision Act, we looked at the deliberation of medical institution ethics committees on decisions to discontinue life-sustaining treatment for patients without family ties.Under the current law, the medical institution ethics committee cannot make decisions on discontinuation of life-sustaining treatment for unbefriended patients, so through revision, matters regarding decisions on discontinuation of life-sustaining treatment for unbefriended patients are reflected in Article 14 of the same Act or separate provisions for unbefriended patients are made. It is necessary to establish and amend new provisions. In addition, the medical institution ethics committee must make a decision on unbefriended patients, but if the medical institution cannot make such a decision, there is a need to revise the law so that the public ethics committee can make decisions, such as discontinuing life-sustaining treatment for unbefriended patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.10
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• pp.243-249
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• 2019

This study examined the patient's advantage and respect self-decision to protect human dignity and values, who are on the pathway of the hospice palliative care and death process. The study subjects were the elderly who had signed the advance medical directives at C Christian religious facilities in S region. The survey period was started on July 1st, 2019 and lasted for ten days. The study resulted in four topics and eight sub-topics on the motivation for preparing advanced medical directives. The four topics were 'for children', 'fear of pain', 'want to clear my life', 'felt the necessity', and the sub-topics were 'don't want to make a burden to children', 'don't want to make a worry of medical expenses', 'fear of pain', 'have experience of taking caring of painful death process', 'relaxed mind', 'importance of self-decision', 'have known it before but now decided', and 'it is the new information and decided'. This research is meaningful in that it can form the basis for improving well-dying education programs for the good death of the elderly and supplementing effective systems for preparing advance medical directives.

• Hospice
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• s.64
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• pp.2-5
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• 2017