• Title/Summary/Keyword: Advanced Directives

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Predictive Factors for City Dwellers' Attitudes toward Death with Dignity (일개 도시주민의 품위 있는 죽음 태도에 대한 예측 요인)

  • Jo, Kae Hwa;An, Gyeong Ju;Kim, Gyun Moo;Kim, Yeon Ja
    • Journal of Hospice and Palliative Care
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    • v.15 no.4
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    • pp.193-204
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    • 2012
  • Purpose: This correlation study was performed to examine Korean adults' perceptions and attitudes towards death with dignity and the withdrawal of life sustaining treatment and to identify factors that predict their attitude towards death with dignity. Methods: The study was conducted using convenience sampling of 291 adults from three towns of a metropolitan city in Korea. Data were collected using structured questionnaires which surveyed people's perception about and attitudes towards withdrawal of life sustaining treatment and scaled their attitude towards death with dignity. Data were analyzed by using descriptive statistics, Pearson correlation coefficients and multiple regression. Results: The attitude towards the withdrawal of life sustaining treatment and death with dignity showed a significant positive correlation (r=0.49, P<0.001). For attitudes towards death with dignity, significant predictors were attitudes towards the withdrawal of life sustaining treatment, age, religion, a proper withdrawal process and advanced medical directives, which explained 49.3% of total variance. Conclusion: The results of this study may contribute to development of a new medical decision-making system including nurses' appropriate roles in the process of withdrawing life sustaining treatment and advanced medical directives.

Death Anxiety and Dignified Death Attitudes of Pre-Elderly Who Opt for Signing Advance Directives (예비노인의 사전연명의료의향서 작성 여부에 따른 죽음불안과 품위있는 죽음태도의 차이)

  • Yang, So Myung;Hwang, Eun Hee
    • Journal of Korean Public Health Nursing
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    • v.34 no.2
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    • pp.251-262
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    • 2020
  • Purpose: This study attempts to provide basic data for establishing and implementing an advanced directive (AD) system that helps identify dignified death attitudes and reduces death anxiety of the preliminary, through preparation of an AD. Methods: Data were collected from 135 preliminary elderly aged 55 to 64 years, recruited from health centers and welfare facilities. All data were analyzed using SPSS 22.0. Results: Overall scores of the participants were 2.26±0.64 for death anxiety scale, and 3.16±0.44 for dignified death attitude. Scores of individuals who prepared an AD were determined to be 2.19±0.64 for death anxiety, and 3.34±0.44 for dignity of death. The difference in scores obtained for dignified death attitude was significantly higher for the group that signed an AD, as compared to the group with no AD (F=14.81, p<0.001). Conclusions: Results of this study reveal that preliminary elderly who sign an AD have a higher dignified death attitude score as compared to subjects who do not sign an AD. Additionally, the former group of participants desire a dignified end to their life. This indicates a necessity to promote public campaigns for ADs, and to develop educational programs that assist the elderly to prepare for a dignified death and make autonomous decisions.

The Effect of Cancer Patients' Knowledge of Advanced Directives and Perception of Good Death on Attitude toward Withdrawal of Life-Sustaining Treatment (암환자의 사전연명의료의향서 지식과 좋은 죽음 인식이 연명의료중단 태도에 미치는 영향)

  • Park, Sang-Un;Kang, Yong-Sil
    • 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.

Training of Fuzzy-Neural Network for Voice-Controlled Robot Systems by a Particle Swarm Optimization

  • Watanabe, Keigo;Chatterjee, Amitava;Pulasinghe, Koliya;Jin, Sang-Ho;Izumi, Kiyotaka;Kiguchi, Kazuo
    • 제어로봇시스템학회:학술대회논문집
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    • 2003.10a
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    • pp.1115-1120
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    • 2003
  • The present paper shows the possible development of particle swarm optimization (PSO) based fuzzy-neural networks (FNN) which can be employed as an important building block in real life robot systems, controlled by voice-based commands. The PSO is employed to train the FNNs which can accurately output the crisp control signals for the robot systems, based on fuzzy linguistic spoken language commands, issued by an user. The FNN is also trained to capture the user spoken directive in the context of the present performance of the robot system. Hidden Markov Model (HMM) based automatic speech recognizers are developed, as part of the entire system, so that the system can identify important user directives from the running utterances. The system is successfully employed in a real life situation for motion control of a redundant manipulator.

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Study on the Policy Directives for Activation of a Senior Employment (시니어계층의 취업활성화를 위한 정책방향 연구)

  • Kwon, GI-Chang
    • The Journal of the Korea Contents Association
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    • v.14 no.10
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    • pp.124-136
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    • 2014
  • Nowadays Korea, where the elderly comprise 11.7 percent of the population had approached to an aging society. In these situations, the purpose of this study is to investigate a employment policy directives of a senior for the employment activation. For this study. we divided the employment policy with a law aspect, a programmatic aspect and a social aspect. And researched about the employment policy case of advanced countries. In the law aspect, this study suggested that they should extend age-limited, strengthen the law and unify the policy actors. In the programmatic aspect, this study suggested that they should change the program goal, make diversification of programs and expand the education students. In the social aspect, this study suggested that they should promote the cognizance change and private participation about senior policy. This study was conducted for the employment activation of a senior.

Nurses' Experiences of Do-Not-Resuscitate (DNR) by the Narrative Inquiry (내러티브 탐구를 통한 심폐소생술금지 (DNR) 환자 간호경험)

  • Woo, Mi Kyung;Kim, Miyoung
    • Korean Journal of Adult Nursing
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    • v.25 no.3
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    • pp.322-331
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    • 2013
  • Purpose: This study was conducted to understand the meaning of the DNR experiences of nurses. Methods: The data were collected through in-depth interviews, observation, and field records with five nurses from November 2009 to February 2011. The data were analyzed using narrative inquiry methodology. Results: Three fundamental themes were derived from data analysis as following: 'faithfulness to care for comfort,' 'helping for peaceful farewells between the patient and the family,' 'reflecting one's lives with a collision of feeling toward the death.' Conclusion: The results indicate that nurses take a role of an advocate in caring for DNR patients and being concerned about their families' conflict and anguish. In addition, this study indicates the importance of education on living will, advanced directives and preparation for the death tailored to the public including healthcare professionals.

Palliative and end-of-life care for heart failure patients in an aging society

  • Okumura, Takahiro;Sawamura, Akinori;Murohara, Toyoaki
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1039-1049
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    • 2018
  • The populations of Asian countries are expected to age rapidly in the near future, with a dramatic increase in the number of heart failure (HF) patients also anticipated. The need for palliative and end-of-life care for elderly patients with advanced HF is currently recognized in aging societies. However, palliative care and active treatment for HF are not mutually exclusive, and palliative care should be provided to reduce suffering occurring at any stage of symptomatic HF after the point of diagnosis. HF patients are at high risk of sudden cardiac death from the early stages of the disease onwards. The decision of whether to perform cardiopulmonary resuscitation in the event of an emergency is challenging, especially in elderly HF patients, because of the difficulty in accurately predicting the prognosis of the condition. Furthermore, advanced HF patients are often fitted with a device, and device deactivation at the end of life is a complicated process. Treatment strategies should thus be discussed by multi-disciplinary teams, including palliative experts, and should consider patient directives to address the problems discussed above. Open communication with the HF patient regarding the expected prognosis, course, and treatment options will serve to support the patient and aid in future planning.

Decontamination of Mercury Contained in CCFLs (Cold Cathode Fluorescence Light) Disassembled from Waste LCDs (Liquid Crystal Display) (폐 LCD (Liquid Crystal Display) 해체 후 분리된 CCFL (Cold Cathode Fluorescence Light) 내 수은의 건식 제거 공정)

  • Park, Jae Layng;Lee, Sungkyu;Kang, Leeseung;Lee, Chan Gi;Cho, Sung-Su;Hong, Myung Hwan;Hong, Hyun Seon
    • Resources Recycling
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    • v.23 no.2
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    • pp.61-70
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    • 2014
  • LCD televisions and monitors use cold cathode fluorescence lamps (CCFLs) to illuminate the screen. Most CCFLs contain mercury and they have to be carefully handled at the end of their lives as per minimum treatment standards under the Waste Electrical and Electronic Equipment (WEEE) and Restriction of Hazardous Substances (RoHS) directives. CCFLs were carefully separated from mold frames of waste LCD units for primary decontamination of mercury/fluorescent compound mixture using CCFL decontamination system designed and fabricated in the present research. Residual mercury was further removed by employing a pyro-process, where crushed CCFL tubes transferred from primary decontamination process were subject to heat treatment at $550^{\circ}C$ in a box furnace: more than 99% of mercury was removable from waste CCFLs.

Recognition of Advance Directives by Advanced Cancer Patients and Medical Doctors in Hospice Care Ward (호스피스병동 말기 암 환자 및 내과의사의 사전의료지시(서)에 대한 인식)

  • Sun, Der-Sheng;Chun, Yeon-Joo;Lee, Jeong-Hwa;Gil, Sang-Hyun;Shim, Byoung-Yong;Lee, Ok-Kyung;Jung, In-Soon;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.20-26
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    • 2009
  • Purpose: We undertook this study to find out the recognitions of terminal cancer patients and doctors about advance directives (ADs), of how they would do in non-response medical conditions and whether ADs could be one of medical options for their dying with dignity. Methods: One hundred thirty four cancer patients in the Hospice Unit, St. Vincent's Hospital, and 97 medical doctors in the Department of Internal Medicine, Catholic Medical Center, were asked about ADs, including Do-Not-Resuscitate (DNR), medical power of attorney, living will and medical options. Results: One hundred thirty patients (97%) and 38 doctors (39.2%) were unfamiliar with ADs, however, 128 patients (95.5%), 95 doctors (97.9%) agreed with it. Seventy nine patients (59.0%) and 96 doctors (99.0%) wanted DNR rather then intensive treatments if they were in non-response medical conditions. Eighty four patients (62.7%) and 75 doctors (77.3%) were agreeable to medical power of attorney. One hundred Thirty four patients (100.0%) and 94 doctors (96.9%) did not want medical options to be in terminal conditions, and hoped to die in peace. Conclusion: Most of patients did not know about ADs and how to make it. However, they showed positive attitudes about it. If we advertise it properly, it is highly likely that a large number of cancer patients would make their living wills easily by ADs. Nevertheless, many legal and ethical problems have to be solved. Doctors should engage their patients in an ongoing communication about the end-of-life. Therefore, let the patients have opportunities to plan their own deaths.

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Community Dwellers' Perception of Past Life Recollection and Preparation for Death (서울시 일 지역 주민의 인생회고 및 죽음준비 인식)

  • Kang, Kyung-Ah;Lee, Kyung-Soon;Park, Gang-Won;Kim, Yong-Ho;Jang, Mi-Ja;Lee, Eun
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.81-90
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    • 2011
  • Purpose: This study is to understand how community members perceive past life recollection and preparation for death. Methods: Using a questionnaire, we surveyed 160 adult residents of one of the districts (gu) in Seoul, Korea. Descriptive statistics were used. Results: Participants chose their 30s and 40s as the most difficult time in their lives. The most painful experience was "an illness of a family member", followed by "trouble with a spouse", and "trouble with children". As for the most difficult social experience, "sense of loss in life" was ranked the highest. Personally, the happiest time was "accomplishment of a goal", while it was "happiness through children" in family relationship and "contribution to society through my career" in social life. As for the most regrettable experience, personally "having lived without purpose" was the highest, "not meeting my parents' expectation more" in family relationship; "not providing sufficient education" in relationship with children; "not having an occupation that I wanted" in work life, and "lack of social skills" in social life. More than 87% of the surveyed showed a positive attitude about the system of the do not resuscitate (DNS) order. For a situation where participants were supposed to have an incurable disease, "I want to be notified of the true condition" and "I want to write a will and advanced directives" ranked high, receiving more than 3.1 points out of 4. Conclusion: These results demonstrate the need for death education to provide people with an opportunity to accept their regrettable experiences in the past as part of their life. Also, this study suggests the importance of writing advanced directives for people to prepare for "death with dignity" how it can help their decision to be better respected.