• 중환자간호학회지
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• 제3권2호
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• pp.91-99
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• 2010

Purpose: The purpose of this literature review was to describe the roles of advanced practice nurses related to advance directives. Methods: A comprehensive literature review was conducted utilizing Pubmed, Ovid, and CINAHL. The key words for search were 'advance directives', 'living wills', 'durable power of attorney', 'advanced practice nursing', 'advanced practice nurse', 'nurse practitioner', and 'nurse specialist'. Research articles published between January 1990 and September 2010 and written in English were included. Review papers and expert's opinion were excluded. Results: Five articles were yielded and analyzed. Among them, two focused on the advanced practice nurses' role during the process of advance directives. The other three presented the outcomes depending on the type of nurses' involvement in each health care delivery system. Conclusion: Recently, Korea established advance directives and expanded to diverse sites. Advanced practice nurses' role in the advance directive decision-making process should be examined and developed in research and practice.

• 대한통합의학회지
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• 제7권4호
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• pp.181-191
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• 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.

• 한국농촌간호학회지
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• 제8권2호
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• pp.65-73
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• 2013

Purpose: The purpose of this study was to identify the relationship between intention to use advance directives and level of death anxiety in community-dwelling elders. Method: The participants were 200 older adults who were aged 60 or over and attended the community welfare centers. The level intention to use advance directive was measured by a questionnaire that was developed by the authors for the study. The measure by Kraus and Ellisond was administered to evaluate the level of death anxiety. Result: The average score for intention to use advance directives was $2.05{\pm}0.88$ and that of death anxiety was $6.2{\pm}2.28$. There were significant differences in the intention to use advance directives according to education levels and individual properties. Although there was no significant relationship between the intention to use advance directives and the level of death anxiety, they were negatively associated. Therefore, older adults who had lower death anxiety would tend to use advance directives. Conclusion: It would be necessary to screening the level of death anxiety to promote use of the advance directives. In addition, education programs for advance directives would be essential to consider about advance directives for their end-of-life especially for the community-dwelling elderly in Korea.

• 한국농촌간호학회지
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• 제14권1호
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• pp.1-7
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• 2019

Purpose: The purpose of this study was to describe nursing students' perception of well-dying and knowledge for Advanced Directives. Methods: Nursing students from one university were selected for the research and a survey was carried out during March and April, 2019. A total of 133 nursing students participated in this study. Data were analyzed using t-test, ANOVA, $x^2$ test with SPSS statistics 21.0. Results: According to the results, the mean score for perception of well dying was $3.00{\pm}0.31$, and knowledge for Advance Directives was $9.05{\pm}2.20$. Perception of well-dying was significantly different by grade group. Knowledge for Advance Directives was significantly different by pre-education experience. Conclusion: In order to improve the nursing students' knowledge for advanced directives, it is necessary to develop education program and provide them through the total school years.

• 한국컴퓨터정보학회논문지
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• 제25권5호
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• pp.169-178
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• 2020

본 연구는 강원도에 거주하는 성인의 사전연명의료의향서에 대한 인식을 알고자 시도되었다. 연구 자료는 강원도에 거주하는 성인 60명을 대상으로 42문항의 구성된 사전연명의료의향서 설문지를 이용하여 수집되었다. 연구 자료는 SPSS 24.0 프로그램을 이용하여 빈도와 백분율을 분석하였다. 사전연명의료의향서 인식의 설문지는 연명치료와 사전의료의향서의 지식, 경험, 선호도로 구성되었다. 연구 결과는 다음과 같았다. 연구 참여자의 45%가 연명치료에 대해 정확이 알고 있다고 응답하였다. 연구 참여자가 선호하는 특수연명치료는 심폐소생술 78.3%, 기계 환기 63.3%, 수혈 51.7% 이었다. 연구 참여자가 피하고 싶어 하는 특수 연명치료는 신장투석 8.3%, 인공호흡 6.7%, 중환자실 입원 6.7%로 나타났다. 사전연명의료의향서에 대해서는 8.3%만 인지하고 있었으며, 그럼에도 불구하고 응답자의 86.6%가 사전연명의료의향서 작성에 호의적이었다. 본 연구 참여자의 사전연명의료의향서에 대한 인식은 매우 낮았음에도 불구하고 이를 준비하겠다는 의도는 높았다. 따라서 이러한 결과를 기반으로 사전연명의료의향서에 대한 인식 수준이 사전의료의향서 작성의도에 매우 중요함을 알 수 있다. 따라서 사전연명의료의향서에 대한 지역 프로그램과 교육과 주기적인 사전연명의료의향서에 대한 인식 연구가 계속되어야 한다.

• 대한통합의학회지
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• 제11권2호
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• pp.87-99
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• 2023

Purpose : This study intended to provide essential data for developing measures for the stable settlement and expansion of the life-sustaining treatment decision system by identifying the effects on preparing advanced directives. Methods : The effects on preparing advance directives of older people were identified based on Andersen's behavioral model, using the 2020 Korean national survey on elderly. Data were statistically analyzed with SPSS Statistics ver 25.0 and the significance level (α) was set to .05. Results : For factors that influence the preparation of advance directives, the predisposing factor was .769 times less for women than men (p=.026). By age, it was 1.410 times higher (p=.006) for people in their 70s compared to people in their 60s and 1.675 times higher (p=.003) for those in their 80s. By the level of education, it was 1.617 times higher (p=.026) for those who have elementary school education compared to those who have no education, 1.596 times higher (p=.048) for those who have a middle school education, 2.313 times higher (p<.001) for those who have a high school education, and 3.827 times higher (p<.001) for those who have a college education. By religion, it was 1.328 times higher (p=.008) for those who have faith compared to those who do not. For possible factors, it was 2.325 times higher (p=.003) for those who spend 100,000 won or more on healthcare (monthly average) compared to those who do not spend. For necessary factors, it was 1.439 times higher (p=.041) for those with the chronic disease compared to those without. Conclusion : It is deemed a measure that can increase the preparation of advance directives, considering the characteristics of each cause, for the stable settlement of the life-sustaining treatment decision system.

• 성인간호학회지
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• 제27권4호
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• pp.449-458
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• 2015

Purpose: The aims of this study were to identify the reported attitudes of older patients with cancer toward advance directives (ADs) and the factors associated with their attitudes toward ADs. Methods: The design was a cross-sectional survey. The age mean of the 130 participants were 70.8, and 66.2% of the participants were male. The data were collected at one university hospital in Seoul, South Korea during the period from October $1^{st}$ to December $5^{th}$ in 2013. The data collecting instruments were the Advance Directives Attitude Survey (ADAS) and questionnaires including socio-demographic and disease-related characteristics, family function. Results: 30.0% of the participants were aware of ADs, only 9% of them had been informed by healthcare providers. Most participants (93.1%) intended to complete ADs. The mean score of ADAS was 48.29. The stepwise linear regression analysis indicated that family function, perceived health status, period of education, and age accounted for a significant percentage (52.0%, p<.001) of the variance in participants' ADAS. The variable with the greatest effect was family function. Conclusion: The findings suggest that family function and attitude of older cancer patients need to be considered for adapting ADs to Korean health care systems. Healthcare providers should include family members in advanced care planning discussions.

• 중소기업융합학회논문지
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• 제6권4호
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• pp.123-129
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• 2016

본 연구는 노인환자의 사전의료의향서에 대한 태도를 결정하는데 영향을 주는 요인을 파악하기 위해 충남 소재 요양병원 5곳과 종합병원 1곳에 입원한 65세 이상의 노인 환자를 대상으로 조화된 설문지를 이용하여 조사하였다. 사전의료의향서에 대한 태도는 2.84점으로 평균이상 수준, 가족기능은 2.73점으로 평균 이하의 수준이었으며, 자기효능감은 3.45점으로 평균 이상의 수준이었다. 연구 결과, 가족기능이 좋을수록 사전의료의향서에 대한 태도가 부정적(r=.-.324, p<.01)이었으며, 자기효능감이 좋을수록 사전의료의향서에 대한 태도가 긍정적인 것으로 나타났다(r=.340, p<.01). 본 연구는 사전의료의향서가 국내에 정착하는데 기여할 것이다.

• 의료법학
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• 제13권2호
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• pp.285-308
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• 2012

The Korean supreme court said that Mrs Kim who was in a persistent vegetative state had a right to die if she had a presumed will or assumption of dying against Severance hospital in 2009. Presumed would be vague and can not be subjective to conjecture though, the court had a developed trial on the case. I recommend the higher valued notion such as the 'right to decide on the life extension' is more logical than assumptive will. To achieve this recommendation, I will search right to life, right to decision, human dignity and find the good relationship between them. In conclusion, I will announce that if PVS patients without advanced directives aren't able to express their will and no one could not assume their right to die in spite of meaningless life extension. So only the due and strict procedure about the extinction of meaningless PVS patients will allow them to sacrifice themselves or remove life extension ventilators. Also active euthanasia would be possible under the strict procedure of making advanced directives and the act of helping active euthanasia additionally, the crime of abetting suicide would not be executed in the legal scope.

• 한국산학기술학회논문지
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• 제20권10호
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• pp.243-249
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• 2019

본 연구의 목적은 호스피스 완화의료와 임종과정에 있는 환자에게 최선의 이익을 보장하고 자기결정을 존중하여 인간으로서의 존엄과 가치를 보호하기 위하여 S시 소재의 C 기독교 종교시설을 방문하여 사전연명의료의향서를 작성한 노인을 대상으로 사전연명의료의향서 작성의 동기를 알아보기 위해 시행되었다. 조사 기간은 2019년 7월 1일부터 10일간 진행하였다. 연구 결과 사전 연명의료 의향서 작성 동기에 관해 4개 주제와 8개의 하위주제가 도출되었다. 주제는 '자식들을 위해서', '고통스러울 것 같아서', '내 삶을 잘 정리하고 싶어서', '필요성을 느껴서' 등의 4가지 주제가 도출되었으며, 하부주제로 '자식들 고생시키고 싶지 않아서', '자식들에게 의료비 부담주고 싶지 않아서', '고통에 대한 두려움이 있어서', '고통스러워하는 가족의 임종을 돌본 경험이 있어서', '편안한 마음을 위해서', '자기결정권의 중요성을 느껴서', '그전부터 알고는 있었지만 이번에 결심하게 되어서', '정보를 처음 알게 되었는데 결심하게 되어서'였다. 본 연구결과는 노인들의 좋은 죽음을 위한 웰다잉 교육 프로그램 개선과 사전연명의료의향서 작성을 위한 효과적 제도를 보완하기 위한 기초자료가 될 수 있다는 점에서 의의가 있다.