• 제목/요약/키워드: End-of-life Care Attitude

검색결과 52건 처리시간 0.024초

농촌지역사회 보건요원의 교육을 통한 주민의 보건복지향상에 관한 사회의학적 연구 (Socio-Medical Approach to the Welfare of Rural Residents Through the Education of Community Health Personnel)

  • 염용태;이명숙;조병희
    • 농촌의학ㆍ지역보건
    • /
    • 제17권1호
    • /
    • pp.34-45
    • /
    • 1992
  • In this county, the gap between the urban 'haves' and the rural 'have-nots' continues to be an increasing problem. WHO and UNICEF see primary health care(PHC) as the key to achieving an acceptable level of health throughout the world as a community development. PHC is essential health care made accessible to individuals and families in the community by means acceptable to them. It is the first level of contact of individual, the family, and community with the national health system. It includes at least education on health system. It includes at least education on health problems, promotion of food supply, MCH including family planning, immunization against infectious diseases, control of endemic diseases, treatment of common diseases and injuries, promotion of mental health, and provision of essential drugs. However, of the aboves, education concerning of mental health problems and the methods to identify, prevent, and control them is the principal step of establishment. In Korea, the category of PHC worker includes the physician as public doctor and nurse as primary health care practitioner and community health leader as village health worker. PHC workers of the aboves will thus function best if they are appropriately trained to respond to the health needs of the community. However in this country, since the national PHC service project launched in 1980, the government has not developed and performed appropriate and enough education and training activities. In light of above reasons, several categories of health education activities had been planned and performed being aimed at above specific target groups and the main focus was on the village health workers for about one year from July 1991 to July 1992 in Yeoju Kun of Kyonki Province. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. The totals of 80 village health workers, 13 public health practitioners and 9 public docters took in the course of health education for a few hours at every month and the evaluation works of educational effect were taken. The results the study were as follows. 1) Number of persons who realized the maxim "health care of the people is a duty of the government" increased after the education course, On the other hand, the rate of satisfaction on the effort of government for health promotion of the people decreased. 2) Public doctors and primary health care practitioners(nurses) liked and enjoyed the education schedule as a meeting of peer group. It provided chances of communication with staffs of Korea University Hospital. It was said that lectures covered great deal of knowledge and technic they urgently needed in the field. 3) After finishing the education course, more of village health workers(VHW) thought they adapted themselves to their roles and functions showing increased number of home visit and contact with primary health care practitioners by month. 4) In case of patient refer, VHW preferred primary health care practitioners to public doctors. 5) Capability of VHWs in most of their functions increased dramatically after when the education course finished except tuberculosis control.

  • PDF

의료인의 호스피스가정간호에 대한 지식과 태도 조사연구

  • 김옥겸
    • 호스피스학술지
    • /
    • 제2권2호
    • /
    • pp.28-48
    • /
    • 2002
  • The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion. Nurses were reluctant to suggest hospice home care to the physicians, as 48.8% of the nurses said they did not want to. From the result of this study the following conclusion can be drawn, the medical profession's awareness of general hospice care has been increased greatly compared to the results of the previously performed studies. However, this study result also shows that their knowledge of hospice home care is not good enough yet. There is a need for high recommended that medical education institute and develop regular courses on various types of hospice care. Medical field training courses for physicians and nurses will be very helpful as well. It is also important to train hospice experts such as palliative physicians and develop a national hospice management urgently in order to improve the hospice care in Korea.

  • PDF

말기암환자에서 심폐소생술금지 (Do-not-resuscitation in Terminal Cancer Patient)

  • 권정혜
    • Journal of Hospice and Palliative Care
    • /
    • 제18권3호
    • /
    • pp.179-187
    • /
    • 2015
  • 환자가 죽음에 임박했을 때 환자, 보호자, 의사 사이에서 심폐소생술에 대한 논의는 피할 수 없는 주제이다. 환자가 회복 불가능한 말기의 암환자인 경우에는 환자의 품위 있는 죽음을 고려하여 심폐소생술을 시행하지 않음(Do-not-resuscitate, DNR)을 결정하게 된다. 그러나 DNR에 대한 선택은 환자와 보호자의 심폐소생술과 DNR의 의미 및 그 결과에 대한 이해를 바탕으로 한다. DNR에 대하여 환자, 보호자, 의료진이 상담을 할 때는 환자의 질환이 더 이상 치료가 불가능하며, 심폐소생술이 환자의 생명을 연장시키는 것이 아니라 죽음의 과정을 연장시키는 것이며, 심폐소생술 이후에 삶의 질이 급격히 나빠질 수 있는 상황이라는 합의가 필요하다. 충분한 이해는 환자 또는 보호자가 품위 있는 죽음을 위한 DNR을 선택하도록 한다. 국내에서는 DNR 자체 보다는 이미 생명유지장치를 가지고 있는 환자에서의 생명유지장치의 제거에 대한 법적인 문제가 2차례 발생하면서 사회적으로 품위 있는 죽음에 대한 일반 대중의 관심이 이전보다 증가하였다. 환자와 의료진을 대상으로 한 설문에서는 DNR에 대한 인식과 의지가 80년대에 비해 2000년대 초반에 이르러 상당히 증가하였으나, 실제 의료 현장에서는 DNR의 결정에 있어 환자가 직접 관여를 하는 경우는 많지 않았고 DNR 작성 시점과 사망 시점과의 시간 간격이 1주 이내로 환자가 관여를 하거나 임종시기의 의료를 결정하기에는 너무 짧은 문제가 있었다. 이러한 문제는 조기 완화의료의 확산을 통하여 개선이 가능할 것으로 생각된다. 일부에서는 DNR이라는 용어보다는 자연적인 죽음을 허용함(Allow-Natural-Death)이라는 용어로 바꾸어서 설명하는 것이 이해를 돕고 선택의 갈등을 줄인다는 보고를 하여 DNR 논의와 결정에 있어서 적절한 시기 이외에도 환자와 보호자에게 많은 어려움이 있다는 것을 보여 주고 있다. DNR은 말기암환자에서 품위 있는 죽음을 위해 고려해야 하는 사항이며, 임상에서 DNR이 잘 시행되도록 임상적, 제도적 노력이 필요하다.

Changes in Perceptions and Attitudes of Medical Students toward End-of-Life Care after Hospice and Palliative Medicine Education

  • Cha, Jeehyun;Lihm, Hoseob;Kim, Yoonyoung;Kang, Jihun
    • Journal of Hospice and Palliative Care
    • /
    • 제22권4호
    • /
    • pp.166-173
    • /
    • 2019
  • 목적: 높은 수준의 호스피스 및 완화의료 교육은 한국 의과대학 교육과정에 필요하다. 하지만 이와 연관된 연구는 많지 않은 실정이며 이에 본 연구는 호스피스와 완화의료 교육 과정을 마친 의과 대학생의 호스피스와 완화의료에 대한 인지 및 태도 변화를 연구하기 위해 수행 되었다. 또한 의과대학의 기본 교육 과정 안에서 호스피스 교육과정의 역할에 대해서도 탐구하고자 한다. 방법: 호스피스와 완화의학에 대한 통합적인 교육과정을 마친 총 76명의 의학과 4학년 학생이 자기 기입 형태의 설문조사에 참여 하였다. 교육 과정을 마친 후 수업 전과 비교하여 수업 후의 후의 호스피스 및 완화의료에 대한 지식과 태도를 조사하였다. 결과: 교육 과정을 이수한 이후 가장 큰 변화는 호스피스 및 완화의료 세팅에서 적절한 마약성 진통제를 사용할 수 있는가 하는 부분에서 나타났다(3.50점 vs 5.32 점; P≤0.001). 수업 전과 비교하여 수업 이후 호스피스와 완화의료에 대한 태도를 나타내는 질문인 "나는 호스피스와 완화의료의 목표와 역할을 바르게 알고 있다"고 답한 학생은 17명(22.4%)에서 65명(85.6%)으로 증가하였다. 또한 "예비의사로서 나는 호스피스와 완화의료의 바른 적용 시점을 알고 있다"고 답한 학생은 수업 전의 22명(28.9%)과 비교하여 65명(85.6%)으로 증가하였다. 결론: 통합적인 호스피스 완화의료 교육과정은 의과 대학생의 호스피스 및 완화의료에 대한 인식과 태도를 긍정적인 방향으로 변화시킬 수 있다.

동서양 종교와 철학의 기초 - '죽음'의 문제를 바라보는 두 눈 -

  • 유흔우
    • 대순사상논총
    • /
    • 제16권
    • /
    • pp.69-85
    • /
    • 2003
  • Death has been one of the basic objects in philosophy and religion. Why do people feel afraid about death? Maybe it is because they don't know the situation after death or because they have a wrong idea about it. Someone may think that he/she doesn't care the situation. But this attitude is wrong. We must understand that our attitude about life is shaped by our knowledge of the situation after death. A recurrent theme about death in popular thought is the idea that death is mysterious. As we have seen, it is difficult to formulate a satisfactory philosophical analysis of the concept of death. If it is impossible to analyse the concept of death, then it is impossible to explain precisely what we mean when we say that something dies. It might be said therefore that, in virtue of this fact, death is mysterious. Of course, death is not distinctively mysterious - all other unanalysable concepts are equally mysterious in this way. Reflection on death gives rise to a variety of philosophical questions. One of the deepest of these is a question about the nature of death. Typically, philosophers interpret this question as a call for an analysis or definition of the concept of death. Plato, for example, proposed to define death as the separation of soul from body. However, this definition is not acceptable to those who think that there are no souls. It is also unacceptable to anyone who thinks that plants and lower animals have no souls, but can nonetheless die. Others have defined death simply as the cessation of life. This too is problematic, since an organism that goes into suspended animation ceases to live, but may not actually die. The eastern philosophers proposed to define death as the nonduality of life and death. Taoists, for example, do not believe in the Wheel of Life of the Buddhists nor in the Heaven or Hell of Christianity. Taoists view existence as glorious. The whole Universe, they teach, is a marvelous, vibrant Unity wherein everything, visible and invisible, pulses with energy and changes. As being develops through the experience of existence, its vessels are swept onwards by the mighty stream of the eternal TAO to other forms of expression and activity. Man does not die; he merely extends into new fields. Taoists teach that the end of a person is the return to the Ultimate Reality. "Life is uncertain - Death is certain": This is a well known saying in Buddhism. Knowing very well that death is certain and it is a natural phenomenon that everyone has to face, we should not be afraid of death. Yet, instinctively, all of us fear death because we do not know how to think of its inevitability. We like to cling to our life and body and so develop too much craving and attachment.

  • PDF

수용전념치료(ACT) 기반 요양보호사 직무 소진, 직무스트레스 완화 프로그램 개발과 적용 (Development of Job Burnout and Job Stress Relife Program for the Nursing Care Workers based on Acceptance and Commitment Therapy(ACT))

  • 이옥주;김무영
    • 한국콘텐츠학회논문지
    • /
    • 제21권7호
    • /
    • pp.222-237
    • /
    • 2021
  • 본 연구의 목적은 요양보호사의 직무스트레스 및 직무소진 완화와 치유를 목적으로 ACT 집단상담 프로그램을 개발하고 그 효과를 확인하는 데 있다. 이를 위해 프로그램의 목표 및 이론적 모형, 내용, 운영 및 평가를 구성하였으며 절차에 따라 적용하였다. 주요 연구결과는 다음과 같다. 첫째, 연구대상의 직무스트레스를 측정한 결과 프로그램 참여 집단에서 긍정적인 변화가 있었다. 둘째, 연구대상의 직무소진 수준을 측정한 결과 프로그램 참여 집단에서 긍정인 변화가 있었다. 셋째, 연구대상의 역할갈등 수준을 측정한 결과 프로그램 참여집단에서 긍정적인 변화가 있었다. 넷째, 연구대상의 역할과다 수준을 측정한 결과 프로그램 참여 집단에서 긍정적인 변화가 있었다. 다섯째, 연구대상의 역할모호 수준을 측정한 결과 프로그램 참여 집단에서 긍정적인 변화가 있었다. 본 연구는 실무적 시사점으로서 각종 요양보호사 교육과정에 ACT이론 및 실천방안을 내용에 포함시킴으로서 직무 소진과 직무 스트레스에 대한 대응력을 높이고 궁극적으로 요양보호사의 심리적 유연성을 높임으로서 일과 삶을 대하는 태도의 본질적 변화의 기회를 제공할 것에 대해 기술하였다.

DNR에 대한 간호사의 인식 및 태도조사 (Nurses' Understanding and Attitude on DNR)

  • 한성숙;정순아;문미선;한미현;고규희
    • 간호행정학회지
    • /
    • 제7권3호
    • /
    • pp.403-414
    • /
    • 2001
  • The study was intended to identify the nurses' experiences, understanding, and attitudes on DNR. Also, the study was to provide the data base for a standard of DNR decision-making and practice. The sample consisted of 347 nurses in eight general hospitals. The data were collected between August 1 and August 31, 2000. The data were analyzed using descriptive statistics and $x^2-test$. The results of the study were as follows : 1. Regarding DNR-related experience, 74.6 percent of the participants experienced DNR situations. Eleven percent of the participants received DNR education. DNR was most frequently (81.5%) requested by family members and relatives of patients. The decision-making on DNR was most frequently (76.8%) made by agreement between family members and medical staff. The DNR order was recorded at 81.9 percent on charts. Problems after DNR order were negligence in treatment and nursing care (30.6%) and guilty feelings due to doing the best (22.1%). CPR (cardiopulmonary resuscitation) was performed about 49.8 percent of DNR cases. 2. Regarding understanding and attitude on DNR, most of the participants (93.1%) thought DNR was necessary. The major reasons for the necessity of DNR were impossible recovery (44.4%) and death with dignity (41.1%). The decision-making on DNR was most frequently made by patient and family members (47.8%) and followed by agreement between family members and medical staff (25.6%), and patients themselves (16.4%). Most of the participants thought that medical staff must explain DNR to critical and end-of-life patients and their family members. Forty four percent of the participants thought that the most appropriate time for DNR explanation was when patients with critical disease were admitted to hospitals. Most of the participants (90.2%) thought a guide book for DNR is necessary to be made in hospitals. 3. There were significant differences in the participants' understanding and attitudes on DNR according to religion career education and experience of DNR. Of the participants those who have religions and education experience on DNR thought that there would be more DNR requests after DNR is explained to patients and family members (p<.05). In addition, there was higher understanding on the necessity of DNR in those who have more career and DNR experience(p<.01). The findings of the study suggest that a guide book for DNR need to be made with inclusion of legal, ethical, and cultural aspects. Also, there needs to be more education on DNR in medical ethics to health care professional and to provide more information on DNR to the general public.

  • PDF

대퇴경부 골절 환자의 입원 생활 (The Hospital Life of the Patient with Femoral Neck Fracture)

  • 김경자;지성애
    • 간호행정학회지
    • /
    • 제2권1호
    • /
    • pp.35-56
    • /
    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

  • PDF

Discordance between Physician and the General Public Perceptions of Prognostic Disclosure to Children with Serious Illness: a Korean Nationwide Study

  • Kim, Min Sun;Lee, Jihye;Sim, Jin-Ah;Kwon, Jung Hye;Kang, Eun Joo;Kim, Yu Jung;Lee, Junglim;Song, Eun-Kee;Kang, Jung Hun;Nam, Eun Mi;Kim, Si-Young;Yun, Hwan-Jung;Jung, Kyung Hae;Park, June Dong;Yun, Young Ho
    • Journal of Korean Medical Science
    • /
    • 제33권49호
    • /
    • pp.327.1-327.10
    • /
    • 2018
  • Background: It is difficult to decide whether to inform the child of the incurable illness. We investigated attitudes of the general population and physicians toward prognosis disclosure to children and associated factors in Korea. Methods: Physicians working in one of 13 university hospitals or the National Cancer Center and members of the general public responded to the questionnaire. The questionnaire consisted of the age appropriate for informing children about the prognosis and the reason why children should not be informed. This survey was conducted as part of research to identify perceptions of physicians and general public on the end-of-life care in Korea. Results: A total of 928 physicians and 1,241 members of the general public in Korea completed the questionnaire. Whereas 92.7% of physicians said that children should be informed of their incurable illness, only 50.7% of the general population agreed. Physicians were also more likely to think that younger children should know about their poor prognosis compared with the general population. Physicians who opposed incurable illness disclosure suggested that children might not understand the situation, whereas the general public was primarily concerned that disclosure would exacerbate the disease. Physicians who were women or religious were more likely to want to inform children of their poor prognosis. In the general population, gender, education, comorbidity, and caregiver experience were related to attitude toward poor prognosis disclosure to children. Conclusion: Our findings indicate that physicians and the general public in Korea differ in their perceptions about informing children of poor prognosis.

심폐소생술금지 교육 및 임상 경험에 따른 윤리적 태도 (Ethical Attitudes according to Education and Clinical Experience of Do-Not-Resuscitate (DNR))

  • 계영애;이미연;박진숙;김효주;정태연;장보영;김윤정;구동회
    • Journal of Hospice and Palliative Care
    • /
    • 제18권3호
    • /
    • pp.208-218
    • /
    • 2015
  • 목적: 본 연구는 심폐소생술 비시행(DNR)에 관해 간호사와 의사의 DNR에 대한 인식 및 태도가 DNR 관련 교육 및 임상경험 여부에 따른 차이가 있는지 분석하고자 하였다. 방법: 연구대상은 단일대학병원에서 근무하는 간호사와 의사로서 총 310명이었으며, 자료수집 기간은 2013년 8월 19일부터 8월 30일까지였다. 연구도구는 DNR에 관해 간호사와 의사의 임상 경험과 윤리문제에 관한 인식 및 태도를 조사하기 위해 연구자들의 문헌고찰을 통해 30문항으로 구성된 설문지를 사용하였다. 결과: 본 연구의 참여자 중에 간호사는 238명(77%), 의사는 72명(23%)이었다. 대부분의 참가자들(99%)이 DNR의 필요성에 동의하였고 이유로는 환자의 편안하고 품위 있는 죽음(52%), 회복이 불가능한 의학적 상태(23%), 환자 본인의 죽음에 대한 선택(19%)의 순이었다. DNR 임상경험에 따른 차이는 DNR 필요성의 동의, DNR 시기 및 DNR 이후의 다른 치료의 허용에 대해서 차이를 보였다. 그러나 DNR 교육 여부에 따른 차이는 DNR 시기 이외에는 유의한 차이를 보이지 못하였다. 결론: 본 연구를 통해 DNR에 대한 교육보다는 임상에서의 경험이 실제 DNR에 대한 인식 및 태도에 유의한 영향을 미치는 것을 보여주었기에 효과적인 DNR 교육을 위하여는 실제 임상 실습을 통한 교육이 필요할 것으로 생각된다.