• 동서간호학연구지
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• 제23권1호
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• pp.1-8
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• 2017

Purpose: This study aimed to provide basic data of nursing student's knowledge and attitudes towards the withdrawal of life-sustaining treatment. Methods: Nursing students from two universities in J province participated in this study. The descriptive statistics, t-test, one-way ANOVA, Scheffe test and Pearson's correlation coefficient were used to analyse the data. Results: The nursing students' knowledge of the withdrawal of life-sustaining treatment was 7.42 out of 16. The participants' attitude toward the withdrawal of life-sustaining treatment was 50.03 out of 95 which was 2.64 in its mean rating. Regarding their knowledge of the withdrawal of life-sustaining treatment, nursing students whose family members experienced the life-sustaining treatment had significantly higher knowledge than those students whose not (p<.001). Those participants who support patients or their families' right to decide the withdrawal of life-sustaining treatment had positive attitude toward the withdrawal of life-sustaining treatment (p=.007). In addition, the knowledge of and attitude toward the withdrawal of life-sustaining treatment showed significant correlations (r=.639, p<.001). Conclusion: The findings of this study suggest that systematic and professional education is needed for nursing students to equip positive attitude toward the withdrawal of life-sustaining treatment in nursing practice.

• Journal of Hospice and Palliative Care
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• 제24권1호
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• pp.36-45
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• 2021

Purpose: This study examined the relationship between Knowledge of Life-sustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment among nursing college students, and attempted to identify the mediating effect of Role Perception on Life-sustaining Treatment in that relationship. It is hoped that the findings will ultimately contribute to the development of active nursing strategies. Methods: The participants were 142 nursing college students in the third and fourth years of study who had experienced clinical practice at two universities in cities Y and C. Data were collected from November 1 to 30, 2019. For data analysis, SPSS for Windows version 22.0 was used to calculate descriptive statistics, the t-test, Pearson's correlation coefficients, and multiple regression. To analyze the mediating effect, the Baron and Kenny bootstrapping method was used. Results: Attitudes toward Withdrawal of Life-sustaining Treatment of nursing college students had a significant positive correlation with Knowledge of Life-sustaining Treatment Plans (r=0.34, P<0.001) and Role Perception on Life-sustaining Treatment (r=0.44, P<0.001). Role Perception on Life-sustaining Treatment partially mediated the relationship between Knowledge of Life-sustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment (95% CI, 0.446~1.055). Conclusion: Based on the results of this study, improving nursing college students' Role Perception on Life-sustaining Treatment could be used as a coping strategy to establish positive Attitudes toward Withdrawal of Life-sustaining Treatment.

• 한국컴퓨터정보학회논문지
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• 제23권12호
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• pp.171-177
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• 2018

Purpose : This study is conducted to research the attitude of social workers toward withdrawing life sustaining treatment and compare and analyze the different types of their attitudes. Methods : Research design of this study is Q methodology approach. The study population is 23 social workers. Q sample to investigate the attitude of social workers toward withdrawing life sustaining treatment included 30 statements. After listening to the purpose and method of the study, the 23 social workers agreed to fill out a survey asking sociodemographic information and have been forced to be distributed in 9 scale Q-sample. Results : The collected data was processed through QUANL PC program, sorted into 3 types as followings. The first type was 'the pursuit of quality of life' that the quality of life is more important than the length of life, the second 'choosing to withdraw life sustaining treatment' that they want to write or encourage family to write advanced directive, the third 'withholding life sustaining treatment' regardless of the cost. Conclusion : In conclusion, the social workers attitudes toward withdrawing life sustaining treatment were grouped as three different types, the first type was 'the pursuit of quality of life', the second 'choosing to withdraw life sustaining treatment', the third 'withholding life sustaining treatment'.

• 임상간호연구
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• 제28권3호
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• pp.289-298
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• 2022

Purpose: Nursing stress on life-sustaining treatment of nurses is a significant contributing factor to nursing care performance and patient care outcomes. We need to investigate the factors associated with nursing stress on life-sustaining treatment in hospital settings. The purpose of this descriptive study was to examine the relationship of role perception of life-sustaining treatment and good death perception with nursing stress on life-sustaining treatment among nurses in hospital settings. Methods: Using a cross-sectional study design, we recruited nurses at a hospital located in a metropolitan city in Korea. The nurses completed structured questionnaire questions which were composed of well-validated questionnaires. Descriptive statistics and hierarchical multiple regression model were utilized for data analysis. Results: A total of 205 nurses participated in the study (female 93.2%; aged 20~29 years 63.0%; single status 78.5%). In the hierarchical multiple regression model, there was a significant positive relationship between role perception of life-sustaining treatment and nursing stress on life-sustaining treatment (β=.27, p<.001). Higher education level and working at a ward setting were also significantly related to nursing stress on life-sustaining treatment (β=.13, p<.046 for education level; β=.22, p=.001 for work setting). However, there was no relationship between good death perception and nursing stress on life-sustaining treatment. Conclusion: Education programs to reduce nursing stress on life-sustaining treatment are needed to develop for nurses who have higher role perception of life-sustaining treatment with higher education level working at ward settings in hospitals.

• Journal of Hospice and Palliative Care
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• 제26권3호
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• pp.112-125
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• 2023

Purpose: This study investigated knowledge, attitudes, and nursing stress related to life-sustaining treatment among oncology nurses. Methods: A descriptive study design was used. Data were collected through a survey from April 1 to May 31, 2022. The participants were 132 nurses working in the oncology ward of a tertiary hospital in Seoul. Data were analyzed using the SPSS 25.0 program with descriptive statics, the independent t-test, analysis of variance, and Pearson correlation coefficients. Results: The average scores for knowledge, attitudes, and nursing stress related to life-sustaining treatment were 14.42, 3.29, and 3.96, respectively. Significant differences in knowledge about life-sustaining treatment were observed based on clinical experience (P=0.029) and education about life-sustaining treatment (P=0.044). Attitudes toward life-sustaining treatment varied significantly with education about life-sustaining treatment (P=0.014), while stress levels differed significantly across working units (P=0.004). A positive correlation was found between the dilemma of extending or stopping life-sustaining treatment (a subdomain of nursing stress) and attitudes toward life-sustaining treatment (r=0.260, P=0.003). Conclusion: There was no significant correlation between the nursing stress experienced by oncology nurses and their knowledge and attitudes toward life-sustaining treatment. However, a more positive experience with life-sustaining treatment education was associated with higher stress levels related to the dilemma of extending or stopping life-sustaining treatment. Therefore, it is crucial to develop strategies to manage this dilemma and reduce stress in the field.

• Journal of Hospice and Palliative Care
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• 제23권3호
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• pp.114-125
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• 2020

Purpose: This descriptive study investigated the effects of nurses' knowledge of withdrawal of life-sustaining treatment, death anxiety, and perceptions of hospice care on their attitudes toward withdrawal of life-sustaining treatment. Methods: Data were collected from 262 nurses at tertiary hospitals, general hospitals, or primary hospitals in Busan, Korea, and statistically analyzed using the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical regression analysis. Results: The participants' scores were 3.68±0.45 (out of 5) for attitudes toward withdrawal of life-sustaining treatment, 0.65±0.15 (out of 1) for knowledge of withdrawal of life-sustaining treatment, 2.61±0.26 (out of 4) for death anxiety, and 4.06±0.43 (out of 5) for perceptions of hospice care. Furthermore, knowledge of withdrawal of life-sustaining treatment and perceptions of hospice care showed positive correlations with attitudes toward withdrawal of life-sustaining treatment, while death anxiety showed a negative correlation. The most significant factors influencing attitudes toward withdrawal of life-sustaining treatment were perceptions of hospice care, followed by having experienced caring for patients who withdrew life-sustaining treatment, death anxiety, having a spouse, and ethical values, and the overall explanatory power was 43.0%. Conclusion: This study showed that perceptions of hospice were an important factor influencing nurses' attitudes toward withdrawal of life-sustaining treatment. Therefore, it is necessary to develop and validate educational intervention programs that can improve perceptions of hospice care.

• 중환자간호학회지
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• 제16권3호
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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.

• 한국보건간호학회지
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• 제32권2호
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• pp.167-180
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• 2018

Purpose: The aim of this study was to identify the life-sustaining treatment choices and related factors among general hospital nurses. Data were collected from June 16 to June 29, 2015. The participants were 244 nurses from five general hospitals in D city. Methods: The data were analyzed using the SPSS 18.0 program, descriptive statistics, paired t-test and one-way ANOVA. Results: Significant differences were observed in the level of life-sustaining treatment choices for nurses to themselves and to their families except for pain control. More nurses declined life-sustaining treatment choices, but suggested their families receive it. The related factors of special life-sustaining treatment choices for nurses themselves and their families according to their general characteristics were age, marital status, education and religion. Conclusion: This study suggests that the related factors need to be considered in the education of nurses' or public health providers' Life-sustaining treatment choices.

• 의료법학
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• 제24권4호
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• pp.103-128
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• 2023

현행 연명의료결정법에 따르면 연명의료를 시행하지 않거나 중단하는 결정은 임종과정에 있는 환자의 의사가 우선적으로 적용된다. 이러한 환자를 대상으로 하는 연명의료의 의사결정은 환자가 의식이 있는 경우에는 환자 본인이 연명의료에 대한 의사를 직접 서면이나 구두로 표시하거나 사전연명의료의향서와 연명의료계획서를 작성하는 것으로 자기결정을 행사할 수 있다. 반면에, 환자가 사전연명의료의향서나 연명의료계획서를 작성하지 않은 경우에는 환자 가족의 진술로 환자의 의사를 확인하거나 환자가족 전원의 동의로 연명의료중단등결정을 할 수 있다. 그러나 가족이 없거나 가족을 알 수 없는 무연고 환자인 경우에는 입원하기 전에 사전연명의료의향서와 연명의료계획서를 작성하지 않은 상태에서 의사표현을 할 수 없는 의학적 상태로 되면 환자의 의사를 알 수가 없어 환자에 대한 연명의료를 지속해야 할지 중단해야 할지에 대한 결정을 해야 하는 상황이 발생한다. 본 연구는 무연고환자의 경우에 연명의료결정을 위한 정책적 방안을 제시하고자 현행법상 무연고 환자에 대한 논의와 방안 검토했다. 첫째로, 성년후견인제도의 적용을 살펴보았지만, 성년후견인은 신체를 침해하는 의료행위에 대한 동의를 대신할 수 있지만 의료행위의 직접적인 결과로 사망할 수 있는 경우에는 가정법원의 허가를 필요로 하기 때문에 임종과정에 있는 급박한 환자에게는 적절한 방안이라고 할 수 없다. 둘째로, 연명의료결정법 제14조에 따라 의료기관윤리위원회에서 무연고 환자에 대한 연명의료중단등결정에 관한 심의에 대해 살펴보았다. 현행법상에서는 의료기관윤리위원회에서 무연고 환자에 대한 연명의료중단등결정을 할 수 없기 때문에, 개정을 통하여 무연고 환자에 대한 연명의료중단등결정에 대한 사항을 동법 제14조에 반영하거나 무연고 환자에 대한 규정을 따로 신설하여 개정하는 것이 필요하다. 또한 의료기관윤리위원회에서 무연고 환자에 대한 결정해야 하지만, 그런 결정을 하는 것에 대해서 해당 의료기관에서 할 수 없다면, 공용윤리위원회에서 무연고환자의 연명의료중단등결정을 할 수 있도록 법률을 개정할 필요가 있다.

• Child Health Nursing Research
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• 제23권3호
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• pp.292-299
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• 2017

Purpose: This study was done to analyze nursing students' attitudes to life-sustaining treatment by measuring their awareness of biomedical ethics and resulting attitude toward withdrawal of life-sustaining treatment. Methods: This study was a descriptive research to assess the level of nursing students' awareness of biomedical ethics, attitude toward withdrawal of life-sustaining treatment, and correlations between these variables. After the nursing students signed a consent form they were assessed. Data collection was done from September 1 to October 25, 2016, and analyzed using SPSS 23.0 WIM Program. Results: There was a negative correlation and significant difference between nursing students' awareness of biomedical ethics and attitude toward withdrawal of life-sustaining treatment. There was a significant correlation among attitude toward withdrawal of life-sustaining treatment and medical ethics, mortality ethics. Conclusion: The findings in the study indicate that it is necessary to provide nursing students with easy access to continuous education to help them establish an acceptable view of withdrawal of life-sustaining treatment.