• Journal of Korean Critical Care Nursing
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• v.16 no.3
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• pp.109-122
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• 2023

Purpose : This study aims to explore nursing activities after the decision to discontinue life-sustaining treatment, awareness of a good death, and perception of life-sustaining treatment decisions among nurses in intensive care units (ICUs) at tertiary general hospitals. Methods : Participants were 173 nurses working in two tertiary general hospitals. The data were collected using structured questionnaires and analyzed using an independent t-test, paired t-test, one-way ANOVA, Scheffé's test, and Pearson's correlation coefficient. Results : Participants were 173 nurses working in two tertiary hospitals. The nursing activity increase was the greatest in the spiritual domain, and the physical domain was where the activities decreased the most. There were significant associations between Awareness of good death (Clinical) and Perception of life-sustaining treatment decision(r=.26, p <.001), Awareness of good death (Closure) and Perception of life-sustaining treatment decision(r=.36, p <.001), and Awareness of good death (Personal control) and Perception of life-sustaining treatment decision(r=.49, p <.001). Conclusion : Based on the results, systematic education programs and job training are required to improve the awareness regarding good death and perception of life-sustaining treatment decision for nurses in ICUs where discontinuing life-sustaining treatment decisions are made.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.405-413
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• 2019

Background Face transplantation has naturally evolved from reconstructive procedures. However, few institutions perform face transplantations, because it is time-consuming and it is necessary to justify non-vital organ transplantation. We investigated the process of organ donation from brain-dead patients and the possibility of incorporating face transplantation into the donation process. Methods A retrospective review was performed of 1,074 brain-dead patients from January 2015 to December 2016 in Korea. We analyzed the time intervals from admission to brain death decisions (first, second, and final), the causes of brain death, and the state of the transplanted organs. Results The patient base (n=1,074) was composed of 747 males and 327 females. The average period between admission to the first brain death decision was 8.5 days (${\pm}15.3$). The average time intervals between the first brain death decision and medical confirmation using electroencephalography and between the first brain death decision and the final determination of brain death were 16 hours 58 minutes (${\pm}14hours$ 50 minutes) and 22 hours 57 minutes (${\pm}16hours$ 16 minutes), respectively. The most common cause of brain death was cerebral hemorrhage/stroke (42.3%), followed by hypoxia (30.1%), and head trauma (25.2%). Conclusions When face transplantation is performed, the transplantation team has 22 hours 57 minutes on average to prepare after the first brain death decision. The cause of brain death was head trauma in approximately one-fourth of cases. Although head trauma does not always imply facial trauma, surgeons should be aware that the facial tissue may be compromised in such cases.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.300-310
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• 2018

The purpose of this study is to compare the change of Well-Dying awareness and decision of university student before and after taking the course of death study. A questionnaire survey was conducted for university students 93 before education, 117 after education who participated in the Death Studies related lectures at Daejeon Metropolitan City for 15 weeks from August to December 2016. The general characteristics of survey are gender, age. grade, major, marriage condition, religion, family member living together and health status. Four items on the perception aspect of death, five items on the aspect of acceptance of death, seven items of death decision and twelve items for death education's interest and importance were configured as a reference scale. The statistical method carried out the chi-square test, the independent sample t-test, and the decision tree analysis. Based on the decision tree, At the time of preparation for death(cancer patient, terminal patient, etc.) and the elderly(65 years old or older), the education transition rate was 66.7%. But After education, 65.3% of the respondents were in adult, middle and high school, under elementary school, university, and graduate school, which showed a significant difference. Therefore we are looking for death education's effectiveness and setting directions for education's period and contents. the negative viewpoints and worries about the implementation of death education at elementary, middle and high schools and universities are resolved and the death education will positively affect the change of attitude of students.

• Health Policy and Management
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• v.33 no.1
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• pp.19-28
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• 2023

Background: With the enactment of the Hospice, Palliative, Care, and Life-sustaining Treatment Decision-Making Act in February 2018, legal guidelines for physician orders for life-sustaining treatment (POLST) were presented. This study was conducted to analyze the association of writing POLST on the use of health care before death. Methods: The study analyzed the electronic medical records and POLSTs of 1,003 adult patients who died at a tertiary hospital located in Seoul from February 4, 2018 to February 4, 2019. Results: Of the deaths, 80% (n=804) completed POLST. Among patients who completed POLST before death, 51% (n=412) were written 1-7 days before death, and only 31% (n=246) were completed by patients themselves. 99% (n=799) decided to withdraw or withhold cardiopulmonary resuscitation. As a result of analyzing the effect of POLST on medical use before death, it was found that POLST and inpatient cost had a significant negative correlation, and POLST completion significantly reduced death in the intensive care unit (ICU). However, both inpatient costs and death at ICU increased when the POLST was completed by surrogate decision-makers rather than patients themselves. Conclusion: The enactment of the Hospice, Palliative, Care, and Life-sustaining Treatment Decision-Making Act provided a legal basis for withdrawing and withholding meaningless life-sustaining treatment. By specifying the treatment to be received at the end of one's life through the POLST, inpatient treatment costs and death at the ICU were decreased. However, the frequent decision-making by the surrogates and completion of POLST close to death may hinder the original purpose of the law.

• The Journal of the Korea Contents Association
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• v.10 no.10
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• pp.304-317
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• 2010

The purpose of this study is to research on attitudes toward legalization of death with dignity. The respondents are 561 adults aged 20 years old and over, living in Seoul and Kyunggi Province. Research questionnaire consist of 28 questions concerning general background, personal experiences of death, attitudes toward death, pros and cons on death with dignity and legalization. Statistical analyses employ frequency, mean, cross tab, and t-test. 87.3% of respondents agree the legalization of death with dignity. The persons who are older, self-employed, and production employees, get married, live with spouse, believe buddhism, experience care for the death, believe life after death, recognize the necessity of testament agree more on death with dignity. The first requisite for legalization of death with dignity is the standard of judgement concerning self decision on death with dignity. The decision makers are prioritized by self, family member in order. The necessary services for decisions on death with dignity are the mediation role between medical team and family, medical information about illness prognosis and prolongation, psychological counselling on depression.

• The Korean Journal of Health Service Management
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• v.12 no.4
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• pp.191-202
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• 2018

Objectives: The purpose of this study was to identify the factors influencing factors university students' will toward brain death organ donation. Methods: Data from 250 students were collected using a structured questionnaire. The data were analyzed using a chi-squared test, independent t-test, and binary logistic regression with the SPSS 23.0 program. Results: Factors influencing will of brain death organ donation were announcing to decision to engage in brain death donation(Confidence interval(CI)=3.02-32.14, p<.001), experience of having discussed brain death organ donation with others(CI=1.26-5.72, p=.011), intention to make advance directives(ADs)(CI=1.90-9.57., p<.001), and positive attitude toward ADs(CI=1.05-1.29, p=.004). Conclusions: The most important factors affecting the will of brain death organ donation were making an informed decision regarding organ donation, intending to make an AD, having engaged in organ donation conversation, and a positive attitude toward ADs.

• Korean Journal of Construction Engineering and Management
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• v.22 no.5
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• pp.55-65
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• 2021

Compared with other industries, construction industry shows a higher rate of death accidents and recently companies' legal responsibilities are to be increasingly enforced. The trend causes tremendous concerns for construction firms and increases the importance of forecasting and pro-actively managing death accidents in construction fields. The objective of the study is to develop a predictive analytics model for forecasting death accidents in building projects based on a decision tree technique, which enables to forecast the probabilities of death accidents by trade. The use of the model helps to decrease risks of legal punishments and to assist the safe execution of building projects by forecasting and pro-actively managing death accidents.

• Journal of Industrial Convergence
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• v.22 no.5
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• pp.107-116
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• 2024

This study is a descriptive research study to determine the extent to which end-of-life care stress, death awareness, and prior decision-making attitudes of nurses at a hospice and palliative nursing institution have an impact on end-of-life care performance. The subjects of this study were 200 nurses working at a hospice and palliative nursing institution. Data collection for this study was conducted from August 9 to September 30, 2021, using two methods: written questionnaire and internet survey. The data analysis method used Pearson's correlation coefficient to analyze the relationship between the subjects' end-of-life care stress, death awareness, prior decision-making attitude, and end-of-life care performance. Hierarchical Regression was used to identify factors affecting the subject's end-of-life care performance. The results of this study showed a significant correlation between end-of-life care performance and death awareness (r=.22, p=.002), and end-of-life care performance and prior decision-making attitude (r=.20, p=.004). And prior decision-making attitude and death awareness had a significant impact on end-of-life care performance. As death awareness and prior decision-making attitudes increased, end-of-life care performance increased, and end-of-life care stress did not appear to be a statistically significant factor influencing end-of-life care performance. In order to improve hospice nurses' ability to provide end-of-life care, intervention that takes into account the influencing factors is required.

• Journal of Digital Convergence
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• v.15 no.8
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• pp.257-265
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• 2017

The purpose of this study was to investigate the degree of awareness of the concept of 'hospice palliative medical care' and decision of 'life-prolonging medical care' by the general public subjects. A survey was conducted on 346 participants and officials who participated in an event held in September 2016. As a result of the research, the subjects' responses results to the life-prolonging medical care decision showed that people with religion wanted natural death compared to people without religion, and had more active attitude toward decisions related to dignity death. Religion is an important factor that can influence perceptions of life and death, believing that afterlife is after death, so it is possible to take a more firm stance on the extension of meaningless life at the last minute. Therefore, in order to stabilize the hospice care and prescription medical decision law to the general public and to improve the quality of the death and the dignity of life, it is necessary to develop awareness through various educational programs in consideration of age, education level. In addition, education and promotion should be strengthened so that the general public can fully understand the knowledge of hospice palliative care and health care and government standardization and policies for hospice personnel and breeding programs will be urgent.

• Journal of Hospice and Palliative Care
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• v.25 no.1
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• pp.42-49
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• 2022

As population aging increases the burden of cancer, the quality of death of patients with cancer is emerging as an important issue alongside their quality of life. To improve the quality of death, it is necessary to prepare for death, allowing patients to die comfortably and with dignity at the end. Considering these issues, I aim to discuss the practical aspects of notifying the patient of the terminal phase of cancer and planning for end-of-life care (i.e., advance care planning). When cancer treatment that can extend the patent's lifespan becomes difficult, the patient enters a treatment transition period. Treatment is shifted from life-prolonging care to life-enhancing care, and end-of-life care must be well planned. Medical providers often worry too much about whether the patient will be disappointed or psychologically traumatized when notified of the terminal phase of their cancer, thus delaying plans for end-of-life care. In fact, patients can accept their condition and prepare for end-of-life care better than we expect. During the treatment transition period, notification of terminal status should be given, and a well-prepared advance care plan should be established early when the patient has decision-making ability. In addition to conveying information, it is always necessary to be sensitive to whether the patient and caregiver understand the information and respond to their emotions.