Purpose: The purpose of this study was to understand the meaning of death experienced by medical and nursing students through end-of-life care practice. Methods: Data were collected by in-depth interviews with twelve (six nursing and six medical) students. Conventional qualitative content analysis was used to analyze the data. Results: This findings were analyzed in three areas: 'feeling from the word of death', 'color association of death', and 'relation between life and death'. Results were three major themes and sixteen categories from the analysis. Three major themes include 'reality of uncertain death', 'have to leave, and 'new perception about death'. Sixteen categories include 'being well', 'fear', 'unknown', 'boundless', 'being with', 'out of sight', 'new start', 'go back to', 'place going by itself', 'place to meet with', 'being transformed', 'a sense of futility', 'the same point', 'a different point', 'continuous line', and 'a crossroad'. Conclusion: The findings suggest a number of themes that nursing and medical students reported about the end of life experiences that could be explored as a way of improving end of life care.
Ha, Beom-Man;Kang, Jong-Won;Chang, Hye-Chung;Yoon, Seok-Jun
Journal of Preventive Medicine and Public Health
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v.34
no.3
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pp.191-199
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2001
Objective : In this study, we focused on estimating the burden of premature death in Korea caused by smoking using the YLL(years of life lost due to premature death) measurement. Methods : First, we determined parameters: such as age-specific standard life expectancy, age on death, sex, and cause of death by analyzing the national death certificate data and life table collected during 1997. These were provided by the National Statistical Office. Secondly, we estimated the age group- specific years of life lost due to premature death by employing the standard expected years of life lost(SEYLL) measurement. Thirdly, the burden of premature death caused by smoking was estimated using the YLLs measurement which was developed by the global burden of disease study group. Fourthly, We calculated the risk related to smoking using the population attributable risk. Results : The following results were obtained in this study: 1) Premature death that is attributable to smoking in males could be prevented in 60.9%(513,582 person-year) by non-smoking. 2) The burden of premature death by smoking for female was prevented to 17.7%(513,582 person-year) by non-smoking. Conclusion : We found that the YLL method employed in this study was appropriate in quantifying the burden of premature death. This provides a rational basis for planning a national health policy regarding premature deaths caused by smoking and other related risk factors.
Purpose: The aim of this study was to examine the effects of death anxiety and perceived end-of-life care competencies on the fear of terminal care among clinical nurses. Methods: This correlational study was conducted from June to July 2021. The study included 149 clinical nurses employed at a tertiary hospital and seven other hospitals. The measurement tools used in this study were the Thanatophobia Scale (Cronbach's α=0.87), the Death Anxiety Scale (Cronbach's α=0.80), and the Scale of End-of-life Care Competencies (Cronbach's α=0.94). These instruments were chosen to assess the levels of fear of terminal care, death-related anxiety, and competencies in end-of-life care. Results: The mean score for fear of terminal care was 3.32±1.32. Differences in fear of terminal care were observed based on the working unit, position, number of patients requiring terminal care, and experience with end-of-life care education. Fear of terminal care was significantly positively correlated with death anxiety and significantly negatively correlated with end-of-life care competencies. In multiple regression analysis, the factors influencing fear of terminal care were attitudes toward end-of-life care competencies (𝛽=-0.39, P<0.001), death anxiety (𝛽=0.24, P<0.001), knowledge of end-of-life care competencies (𝛽=-0.22, P=0.005), and behaviors related to end-of-life care competencies (𝛽=-0.16, P=0.021). These factors explained 64.6% of the total variance (F=25.54, P<0.001). Conclusion: This study suggests that developing nurses' end-of-life care competencies and reducing death anxiety are crucial for managing the fear of terminal care. Therefore, providing end-of-life care education and psychological support programs is important.
Beckett's life-long struggling with death may be illuminated in terms of the Western tradition of thanatology as well as Philippe Ariès's anthropological classification of death. Among the Western tradition, Beckett's oeuvre incarnates memento mori, timor mori, nihilism, theatrum mundi, life as afterlife, and the transsubstantiation of the self. Among the five views of death Ariès suggests, Beckett appears to foreground the death of the self and the invisible dirty death. In a world devoid of transcendental Signified, Beckett's resident is "a poor player/That struts and frets his hour upon the stage." Our contemporary vision of death is dominated by the dirty death and timor mori resurrected from the cultural icon of danse macabre in the late Mediaeval age as vividly dramatized in W;t by Margaret Edson. Beckett stands in no man's land: Lucky complains of divine aphathia as well as scopes at the possibility of God's existence like Hamm. Beckett's way of getting out of the dilemma is laughing a mirthless and dianoetic laugher. To bourgeois class who shudder at the sight of Grim Death after forgettable years of indulgence and addiction to capitalist consumption, Beckett seems to preach, your life is a death-in-life, you are not born yet until you are baptized with existential awakening as Gregor Samsa in Kafka's Verwandlung, or Tolstoy in Confession.
Until 1970's, mankind have not had definite perspectives on what life after the death was like, which is one of the most important problems for them. Their concepts of the 'life and death problem' has been distorted by the dogmas of the established religions such as Buddhism or Christianity on heaven and hell. But the mankind came to have wholly different views on the life after death thanks to the studies by Raymond Moody Jr. or Elizabeth Quebler-Ross in the mid-1970's. This is the studies on the so-called 'near-death experience(NDE)' which made humankind be able to have scientific approach to the life after death for the first time in their history. What attracts our attention at this point is, however, that the arguements of the NDErs on humman destiny accurately coincide with those of the established religions. In the NDE, most of the experiencers have an encounter with the personal being, symbolized by the Light, through whom they learnt that the devotion(or love) to the neighborhood and the gain of the wisdom are the sole meaning of life. With this result, we can recognize why essential virtues maintained by the established religions until now such as ultimate compassion, unconditional love, forgiveness, or insightful learning are so significant, and that our studies of the NDE are very important in this respect.
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 life table is a statistical model for life expectancy and reflects mortality experiences exposed to a particular group of people. The following three issues are prerequisite for constructing the life table : a selection of how to estimate the death probability from observed death rates, a graduation method to smooth irregularity of the death probabilities, and an extension method of the death probabilities for oldest-old ages. To construct the life table that is fittest to Korean mortality experiences, we examine five estimation methods such as Chiang's and Greville's for the death probability, three graduation techniques including Beer's and Greville's formulae, and twelve mathematical functions for the extension of death probabilities for oldest-old ages. We also propose a method to resolve the cross-over problem arising from construction the life table.
The Journal of Korean Academic Society of Nursing Education
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v.9
no.2
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pp.329-339
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2003
The purpose of this study is to consider of meaning in life based on Frankl's theory and to propose of hospice nursing according to conceptual framework of meaning in life. The conceptual framework of meaning in life is composed of 4 phases. According to the first phase, acceptance & awareness of self and life, hospice nurse should helps dying patient to accept limitedness of human existence and death. and according to the second phase, actualization of creative value, hospice nurse can helps dying patient to discover meaning in life through doing a deed for last time before his death. According to the third phase, actualization of experiential value, hospice nurse can helps them to discovery of meaning by experiencing of love through meetings with other people, nature, and god. According to the forth phase, actualization of attitudinal value, hospice nurse can helps them to discovery of meaning by realizing meaning in suffering and death through exercising of the inner freedom to choose bravery and acceptance in the face of death and misfortune. As mentioned above, the Frankl's theory accords with the core of hospice nursing that helps people to accomplish human essence in suffering and death. therefore we accepted Frankl's point of view, asserted that one of the most important roles of a hospice nurse as a supporter and sustainer for dying patients is to help patients to find meaning in life even in the course of death. To achieve the goal, hospice nurses should try to have a firm faith through philosophical introspection about life, death, human existence and meaning in life what the most important goal of life is to discover meaning in life and human have the duty and responsibility of recognizing and pursuing meaning up to the last moment of life.
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.
The Journal of the Convergence on Culture Technology
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v.3
no.4
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pp.27-33
/
2017
Epicurus and Lucretius expressed that death is neither evil to the living nor the dead. On the contrary, our everyday perception of death is that death is evil. Such everyday perception might seem in lack of introspection and blind but our living environment and form of life are strongly supporting this perception. This paper argues that there is reasonable cause for believing death is evil. In order to justify this argue, this paper critically supports Thomas Nagel's 'Deprivation Theory', which identifies the cause of death being in evil in the deprivation of life. This paper investigates the main substances of 'Deprivation Theory, suggests the related problems and therefore reconstitutes the main arguments of 'Deprivation Theory, resulting in the investigation of the following facts; that we cannot avoid the fate of death, but that our existence is headed towards the future, and that as independent individuals we have infinite possibilities of life. Death is natural to humanity as species, but as independent individuals death deprives us from possible life and future. Therefore, death we encounter in our living environment and form of life is evil. As species, we can agree with Epicurus and Lecretius' view, but as independent individuals we cannot share them.
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