• 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.21 no.1
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• pp.1-8
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• 2018

Nearly 20 years after the Boramea Hospital case, the act on decisions on life-sustaining treatment for patients in hospice and palliative care or at the end of life has taken effect on February 4, 2018 as recommended by the National Bioethics Committee. However, during the legislation process, some parts of the bill that stakeholders and concerned parties did not see eye to eye were either revised or removed. Moreover, the hospice and palliative care part was added in the last minute before the enactment. As a result, the law includes parts that are not in line with the recommendations from the National Bioethics Committee, thereby causing various problems. Therefore, it is crucial to monitor how the decisions on life-sustaining treatments are made in the field and gather various opinions of concerned parties to identify and address problems in the early stage of the implementation of the law. Based on the data, the legislation must be amended to fulfill its purpose that is "to protect the dignity and value of human beings by assuring the best interests of the patients and by respecting their self-determination".

• 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.

• Journal of the Korea Society of Computer and Information
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• v.25 no.2
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• pp.181-188
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• 2020

This study was conducted to identify the effects of the degree of death orientation, attitudes toward withdrawing life-sustaining treatment, and awareness of biomedical ethics on paramedic students' own biomedical ethics. The participants of this study were 228 paramedic students from a college located in D city. Data were collected from April to June 2019 through a self-report questionnaire. There was a positive correlation between awareness of biomedical ethics and attitude toward withdrawing life-sustaining treatment (r=.63, p<.001). Multiple linear regression analysis showed that the factors affecting students' awareness of biomedical ethics were religion (β=.12, p=.018) and their attitude toward withdrawal of life-sustaining treatment (β=.61, p<.001), with an explanatory power of 41.0%. Educational programs must focus on attitudes toward withdrawing life-sustaining treatment to improve paramedic students' awareness of biomedical ethics.

• The Korean Society of Law and Medicine
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• v.10 no.1
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• pp.263-305
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• 2009

Is it lawful to withhold or withdraw life-sustaining treatment applied to a patient in a terminal condition or permanent unconscious condition? In Korea, there are no such laws or regulations which control affairs related to the withholding or withdrawal life-support treatment and active euthanasia as the Natural Death Act or the Death with Dignity Act in the U. S. A. And in addition there has had no precedent of Supreme Court. Recently Supreme Court has pronounced a historical judgment on a terminal care case. The court allowed the withdrawal of life-sustaining treatment from a patient in a permanent unconscious state. Fundamentally the court judged that the continuation of that medical treatment would infringe dignity and value of a patient as a human being. And the court required some legal grounds to consider such withdrawal or withholding of medical care lawful. The legal grounds are as follow. First, the patient is in a incurable and irreversible condition and already entered a stage of death. Second, the patient executed a directive, in advance, directing the withholding or withdrawal of life-support treatment in a incurable and irreversible condition or in a terminal condition. Otherwise, at least, the patient's will would be presumed through his/her character, view of value, philosophy, religious faith and career etc. I regard if a patient is in a incurable and irreversible condition or in a terminal condition, the medical contract between a patient and a doctor would be terminated because of the actual impossibility of achievement of it's purpose. So I think the discontinuation of life-sustaining care would be legally allowed without depending on the patient's own will.

• Journal of Hospice and Palliative Care
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• v.21 no.3
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• pp.92-103
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• 2018

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.

• 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.

• Journal of Korean Clinical Nursing Research
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• v.28 no.3
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• pp.289-298
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• 2022

Purpose: Nursing stress on life-sustaining treatment of nurses is a significant contributing factor to nursing care performance and patient care outcomes. We need to investigate the factors associated with nursing stress on life-sustaining treatment in hospital settings. The purpose of this descriptive study was to examine the relationship of role perception of life-sustaining treatment and good death perception with nursing stress on life-sustaining treatment among nurses in hospital settings. Methods: Using a cross-sectional study design, we recruited nurses at a hospital located in a metropolitan city in Korea. The nurses completed structured questionnaire questions which were composed of well-validated questionnaires. Descriptive statistics and hierarchical multiple regression model were utilized for data analysis. Results: A total of 205 nurses participated in the study (female 93.2%; aged 20~29 years 63.0%; single status 78.5%). In the hierarchical multiple regression model, there was a significant positive relationship between role perception of life-sustaining treatment and nursing stress on life-sustaining treatment (β=.27, p<.001). Higher education level and working at a ward setting were also significantly related to nursing stress on life-sustaining treatment (β=.13, p<.046 for education level; β=.22, p=.001 for work setting). However, there was no relationship between good death perception and nursing stress on life-sustaining treatment. Conclusion: Education programs to reduce nursing stress on life-sustaining treatment are needed to develop for nurses who have higher role perception of life-sustaining treatment with higher education level working at ward settings in hospitals.

• 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.

• The Korean Society of Law and Medicine
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• v.13 no.1
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• pp.397-418
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• 2012