• Journal of Korean Critical Care Nursing
• /
• v.11 no.1
• /
• pp.35-45
• /
• 2018

Purpose : Nurses' knowledge regarding advance directives may affect their administration of and confidence towards end of life care. This study aimed to describe the relationships of knowledge, confidence, and learning needs with advance directives among hospital nurses. Method : This cross-sectional study was performed at a tertiary university hospital in Seoul between September 25 and October 14, 2017. Convenience sampling was used to recruit nurses who provided bedside care and had at least 1 year of clinical experience. We used a validated self-report questionnaire. Results : The mean score of knowledge, confidence and learning needs were $5.00{\pm}1.73$, $29.81{\pm}7.52$, and $64.54{\pm}8.48$ respectively. Hospital nurses' knowledge, confidence and learning needs were significantly different according to age, job position, educational level and perceived advance directives. Knowledge regarding advance directives was significantly associated with confidence (r = .27, p < .001) and learning needs (r = .16, p = .005). Conclusion : Knowledge regarding advance directives was relatively low compared to the findings of previous studies. Therefore, nurses should be knowledgeable and encouraged to initiate advance directives. It is necessary to develop a standardized educational program regarding advance directives based on Korean cultures.

• Journal of The Korean Society of Integrative Medicine
• /
• v.7 no.4
• /
• pp.181-191
• /
• 2019

Purpose : This narrative research study aimed to identify the degree of correlation between hospice awareness and knowledge of and attitude toward advance directives. Methods : A survey was conducted from July 5 to July 15, 2018 with 210 adults in C city, Gyeongsangnam-do. Using the SPSS 21.0 program, the data analysis methods utilized were the independent t-test, one-way ANOVA, Scheffe, and Pearson's correlation coefficients. Results : The degree of hospice awareness was measured according to the general characteristics of the subjects, which were as follows: heard about economic level, importance of religion, heard of hospice, heard about advance directives, and intention to execute advance directives. The knowledge of advance directives had significant differences by age, hospitalization experience, religion, and being the final decision maker for a family problem. The attitude toward advance directives differed significantly by marriage status and the intention to write an advance directives. The relationship between hospice awareness and knowledge and attitude toward advance directives showed a positive significant correlation (r=.47, p<001). The relationship between knowledge of and attitude toward advance directives also indicated a positive significant correlation (r=.20, p=.005). Conclusion : This study provided basic data to inform promotion of hospice awareness and an educational intervention about advance directives.

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

• Journal of Korean Academy of Nursing
• /
• v.31 no.2
• /
• pp.279-291
• /
• 2001

Rapid progress in modern medical technology has made it possible to sustain life and/or delay death using 'heroic' treatments. The availability of life-sustaining treatment brings several issues in end-of-life care such as 'dying with dignity' and an radical increase in health care costs. The use of Advance Directives(AD) have been widely heralded by health care providers, gerontologists, and advocacy groups as means of protecting patients' right to accept or refuse life-sustaining treatment in end-of-life care. The use of AD can not only improve patients' autonomy and quality of life but also bring efficiency in distributing health care resources. The proportion of older persons in Korean population has been increasing. Those 65 years of age or over were about 7 percent of the population. Death and dying is not limited to older persons, but it is more prevalent among them. In conjunction with an aging population and the increasing prevalence of death, the issues of death and dying will become crucial in near future in terms of 'dying with dignity', 'autonomy', and 'self-control'. This paper attempts to explode and establish the concept of advance directives (AD) based on literature review. Data sources are computer searches with the MEDLINE database. Due to the lack of prior study on AD for a Korean cases, studies abroad are reviewed. This paper suggests the need for future study on the possibility of the use of AD in Korea.

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

• The Journal of Korean Academic Society of Nursing Education
• /
• v.19 no.3
• /
• pp.330-340
• /
• 2013

Purpose: This study was performed to identify the level of Korean elderly's knowledge regarding concepts of end-of-life (EOL), Life-sustaining-treatment (LST), and advance directives (AD) which are critical aspects for establishing AD in Korean society. Methods: A questionnaire survey was done between October 2011 and February 2012. Knowledge of AD was evaluated with 3 aspects including EOL, LST, and AD utilizing a questionnaire that was developed by authors for the study. Data were collected from 268 community dwelling elderly from three cities and analyzed using descriptive statistics, t-tests, one-way analysis of variance, and a Scheffe post hoc test with SAS Ver. 9.1 program. Results: Overall, Korean elderly were poorly acquainted with AD related concepts. Significant differences in awareness of AD including understanding of EOL, the level of comprehension of LST, and knowledge about AD were revealed by gender, education level, economic state, and acquaintance with terms of AD or LST. Conclusion: To acknowledge autonomy and support quality of life for elderly and to meet the purpose of AD, attention should be given to target populations including elderly in terms of knowledge level related to AD, social marketing, and infra structure relevant to practice AD in our society.

• Journal of Korean Academy of Nursing
• /
• v.42 no.4
• /
• pp.486-495
• /
• 2012

Purpose: The purpose of this study was to explore the main prerequisite for Korean Advance Directives [KAD] to ensure their better use. Methods: Data were collected from two focus group interviews and individual email responses. Study participants were 5 doctors and 6 nurses. All interview data were transcribed and analyzed using qualitative content analysis. Results: Three main themes emerged; establishing a philosophy of KAD, protocol to practice KAD, and the KAD document itself. A philosophy is needed to ensure individual needs, consensus to practice AD and identify principle agents. The core of protocol was found to be as follows; 1) process, 2) premise, 3) procedure, 4) contextual preparation, 5) timing, 6) feasibility. Component and feasibility need to be established for the document itself. Conclusion: For a positive acceptance of KAD in Korean society, a culture sensitive, reality based, and user friendly AD needs to be developed.

• Journal of Korean Clinical Nursing Research
• /
• v.26 no.1
• /
• pp.86-96
• /
• 2020

Purpose: The purpose of study was to provide basic data for developing interventions that could help middle-aged adults prepare for dignified death in the future by examining their attitudes toward death and advance directives (AD), and knowledge of AD. Methods: Data were collected through a survey of 211 middle-aged adults from January 28 to February 28, 2019, in a city located in Gangwon Province. To analyze the data, descriptive statistics, t-test, one-way ANOVA, Scheffé test, Pearson's correlation coefficient and stepwise linear regression were utilized using SPSS/WINdows 21.0. Results: The average score of the participants' attitudes toward death and AD, and knowledge of AD was 91.82±10.89, 15.53±4.27, 46.00±9.45, respectively. There were positive correlations between attitudes toward dignified death and attitudes toward AD, and knowledge of AD. Factors that influence attitudes toward AD were shown in the order of attitudes toward dignified death, knowledge of AD, and intentions to write AD (Adjusted R²=.24). Conclusion: For the dignified death in the future, it is necessary to provide middle-aged adults with an opportunity to think about the need of AD. In addition, extensive education and promotion of AD are required to correct the misunderstanding of AD.

• Journal of Convergence Society for SMB
• /
• v.6 no.4
• /
• pp.123-129
• /
• 2016

This study was conducted to understand influential factors in determining the advance directive attitudes of elderly patients. Structured survey questionnaires were distributed using a convenience sampling method to the residents of long-term-care facilities. As a result, the attitudes toward advance directives were accounted having 2.84 points, the functions of a family with 2.73 points, and the level of self-efficacy with 3.45 points. Participants who have higher family functions were found to have negative attitudes toward self-efficacy, as the relationship between two variables were in the negative correlation (r =-.324, p<.01). However, participants who have higher self-efficacy showed positive attitudes toward advanced directives as the two variables were in the positive correlation (r =.340, p<.01). This study will contribute to the settlement of the AD in Korea.

• The Korean Society of Law and Medicine
• /
• v.17 no.2
• /
• pp.257-279
• /
• 2016

Recently, the Well-dying Act was legislated in Korea, and it will come into effect in August 4, 2017. This Act allows to withdraw the life sustaining treatment from impending death patients and also provide the hospice and palliative treatment to terminal patients. In the Supreme Court's case so called "Madam Kim", medical condition of Madam Kim was a persistent vegetative status owing to brain damage and her family members wanted to remove the artificial ventilation. In 2009, the Supreme Court allowed to withdraw the artificial ventilation under the specific conditions. We applied this new Well-dying Act to the Madam Kim's case hypothetically in order to know this Act can reasonably solve the problem of life sustaining treatment for dying or terminal patients. For the impending patients, the Well-dying Act has the problem not to withdraw the futile treatment due to the advance directives of patients. Vice versa, the terminal patients have no chance to withdraw the life sustaining treatment due to the this Act impose the duty to provide the hospice and palliative treatment despite of advance directives. We need to ruke out the persistent vegetative patients from the terminal patients caused by the cancer, acquired immune deficiency syndrome, chronic obstructive lung disease and chronic liver cirrhosis, In addition, we have to discuss the effect of the advance directives of terminal patients in view of self determination right.