• 제목/요약/키워드: nurse practitioners

검색결과 92건 처리시간 0.02초

전문간호사 업무범위안 제정에 따른 전문의의 업무 위임 의향 (Intention to Delegate Clinical Practice of Medical Specialists in Accordance with the Enactment of the Scope of Practice for Advanced Practice Nurses)

  • 김민영;최수정;김정혜;임초선;강영아
    • 대한간호학회지
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    • 제53권1호
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    • pp.39-54
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    • 2023
  • Purpose: This study aimed to investigate the nationwide intention to delegate clinical practice of medical specialists in accordance with the enactment of the scope of practice for advanced practice nurses (APNs). Methods: Data were collected from October to December 2021 using Google Surveys. In total, 147 medical specialists from 12 provinces responded to the survey. The survey questionnaire was categorized into four legislative draft duties, according to the scope of practice (a total of 41 tasks): Twenty-nine tasks on treatments, injects, etc., performed under the guidance of a physician and other activities necessary for medical treatment (treatment domain); two tasks on collaboration and coordination; six tasks on education, counseling, and quality improvement; four regarding other necessary tasks. Participants were asked whether they were willing to delegate the tasks to APN. Results: The intention to delegate tasks to APN was higher for non-invasive tasks such as blood sampling (97.3%) or simple dressing (96.6%). Invasive tasks such as endotracheal tube insertion (10.2%), sampling: bone marrow biopsy & aspiration (23.8%) showed low intention to delegate in the treatment domain. Participants who were older, male, and had more work careers with APN, showed a higher intention to delegate tasks. Conclusion: To prevent confusion in the clinical setting, a clear agreement on the scope of APN practice as APN delegated by physicians should be established. Based on this study, legal practices that APN can perform legally should be established.

한국 전문간호사의 전망에 관한 고찰: Flexner의 전문직 특성을 기반으로 (Reflections on the Prospects of Korean Advanced Practice Nurses : Based on Flexner's Professional Characteristics)

  • 김은미;최수정
    • 중환자간호학회지
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    • 제16권3호
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    • pp.1-10
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    • 2023
  • Purpose : This study explores the professional status of Advanced Practice Nurses (APNs) in Korea, who, despite being legally certified, face instability in their professional standing, including their scope of practice and compensation. Method : The study uses Flexner's professional characteristics as a framework to analyze and project the future trajectory of Korean APNs. Results : First, to ensure social accountability, professional bodies need to establish uniform nursing policies related to job roles, and healthcare institutions must adhere to these policies. Second, nursing leaders should spearhead the creation of nursing knowledge essential for the profession's advancement, aiming to establish it as the foundation for nursing practice through a consensus process within the nursing community. Third, the curriculum for APNs should enhance the quantitative and qualitative aspects of practice in response to societal needs. Fourth, professional bodies should formulate consistent nursing policies based on a thorough analysis of the healthcare environment and legal considerations, and guide their implementation in clinical practice through a consensus process within the nursing community. Lastly, guidelines should be established for professional standards suitable for the Korean context. Conclusion : Based on this review, it is recommended that all APNs adhere to the professional standards set by their respective organizations, actively participate in personal quality improvement initiatives, and fulfill their duties and roles as members of these professional bodies. Furthermore, these organizations should devise practical strategies to solidify the APN system and should spearhead a systematic consensus process that garners the agreement of all members within the nursing community.

호스피스 팀 구성원의 직무지침 개발 (Development of Task Guidelines for Hospice Team Members)

  • 노유자;한성숙;유양숙;용진선
    • Journal of Hospice and Palliative Care
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    • 제4권1호
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    • pp.26-40
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    • 2001
  • 목적 : 본 연구는 우리나라 호스피스 팀 구성원의 직무지침을 개발하여 앞으로 호스피스 제도화 방안에 기초자료를 제공하기 위하여 수행되었다. 방법 : 관련 국내외 문헌고찰을 토대로 호스피스팀 구성원의 직무 지침안을 설정하여 직무지침에 대한 도구를 개발하였다. 개발된 도구의 내용 타당도를 2차에 걸쳐 전문가에게 우편 설문조사하였다. 1차 조사는 1999년 12월부터 2000년 1월까지 국내 호스피스 기관에 종사하고 있는 실무자 및 호스피스 전문가 126인을 대상으로 하였으며, 2차 조사는 2000년 8월부터 10월까지 35인을 대상으로 하였다. 자료는 조사자가 직접 기관을 방문하여 설문지를 통해 수집하였다. 결과 : 1차 조사에서 호스피스 조정자, 간호사, 사목자, 사회복지사, 약사, 영양사, 치료사, 자원봉사자, 그리고 간호 조무사의 역할과 자격은 CVI가 80.0점 이상인 문항으로 선정하였다. 의사의 자격 중 '마취제 관리 자격증을 소지한 자' 문항은 78.6점 이었고, 자원봉사자 팀장의 자격에서 '대학 이상의 학력소지자' 문항은 74.7점 이었으므로 제외시켰다. 2차 조사에서 호스피스 간호사, 사목자, 사회복지사, 약사, 영양사, 치료사, 자원봉사자, 그리고 간호 조무사의 역할과 자격은 CVI가 80.0점 이상인 문항을 선정하였다. 그러나 호스피스 조정자의 역할 중 '신체적, 사회적, 심리적, 영적 상태를 진단하고 계획한다' 문항이 77.9점이었고, 자원봉사자 팀장의 역할 중 주 1회 팀회의에 참여하고 대상자를 위한 공식적인 간호계획에 참여한다'가 78.6점이었으나 1차에서 80점 이상이었기 때문에 포함시켰다. 결론 : 개발된 직무지침을 적용한 후 수정, 보완하는 과정과 한국 실정에 적합한 호스피스 팀 구성원의 직무지침 표준을 위한 연구가 필요하다.

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여성건강을 위한 개념적 모형 (Conceptual Model for Women s Health)

  • 이경혜
    • 대한간호학회지
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    • 제27권4호
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    • pp.933-942
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    • 1997
  • There has recently been an increased interest in women's health from, various disciplines, with different perspectives presented according to each profession's academic background. This has led to many instances of incorrectly defining, or misinterpretation, of the issues even among professionals. Nurse scholars as well as practitioners who work in women's health care need to have a clear conceptual understanding of women's health in order to build a body of knowledge, delineate curricular activities, and set directions for professional nursing interventions. In addition, a conceptual model that may be directly utilized in practice is needed to maintain and promote women's health issues. The purpose of this study was to apply a Hybrid model, analyzing conceptual definitions and discussions related to women's health gathered from review of the literature. Further to compare analyticals the concepts and properties observed from field work, so as to present a final definition of women's health and, build a conceptual framework for a united comprehensive perspective on the concept as well as on nursing practice. Data collection and analysis consisted of a theoretical stage, field work stage, and final analysis. A heterogeneous group of professionals and lay persons, 39 in all, participated in the field work. Study findings Include several subconcepts under the concept of women's health : a woman's whole life, holistic health, quality of life, awareness of being a woman, individual nursing, self care ability, reproductive health, and family health. Thus, a comprehensive definition was built, 1. e., "Women's health care be defined as improvement in the quality of life of women through attainment of holistic health throughout the life span. With reproductive health at the core, the concept is directly related to family and national health, and includes taking care of one's own health based on awareness of being a woman and utilizing self care activities. Women's health care issues are unique and allow various responses, therefore women's health professionals need to apply individual approaches to reach solutions in attaining holistic health and improving quality of life." The constructual factors of women's health were found to be reproductive functions, diseases more common in woman, self actualization, mental health, women's health policies, sexuality, midlife changes, and marital relations, with each factor having more than three properties. Positive factors affecting women's health were found to be a normal childbearing process, a healthy lifestyle, active health management, health information, support, and resources, and interpersonal relationships. Negative factors were found to be overwhelming role stress, cultural oppression, gender inequality, distorted sexual identity, economic difficulties, misuse and/or abuse of substances, and stress. The model of women's health may be visualized as a balance scale set upon a woman's life, supporting 4 concentric circles. The innermost circle and second circle incorporate conceptual definitions of women's health, and the outer two circles represent the constructional factors and properties of women's health. Each circle has its own color that symbolizes the conceptual meaning. Positive and negative factors are represented as weights at either end of the scale, and are affected by nursing intervention, i. e., health and wellness increase when positive factors are stronger, whereas disease and illness increase when negative factors are stronger. This model is only a preliminary effort and requires much discussion and testing to be further developed. Continuous research is also required.

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가정간호 대상자의 욕창발생 및 간호중재에 관한 조사연구 (A Study on Prevalence and Nursing Intervention of Bed Sore Patients who Received Regional Home Care Services)

  • 김금순;조남옥;박영숙
    • 기본간호학회지
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    • 제4권1호
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    • pp.43-60
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    • 1997
  • This study was to identify the nursing intervention method in finding out the incidence, risk factor, prevention and treatment of bed sore cilents who received regional home care nursing services. The eleven home care nurse practitioners took the survey on 97 patients who received home care nursing service from Seoul City Nurses Association for one month from September 26 to October 26 1996. A modified version of Braden's bed sore assessment tool for bed sore risks and a tool for assessment of bed sore stage and measurement bed sore sizes by Bergstrom, Braden, Laguzza and Holman(1987) were as research tools for this study and a questionnare with 40 questions and 12 items on nursing activities was used to find out the prevention and treatment of bed sores. Also, two open ended questions were used on current approaches and efforts of the treatment being applied to clients. The finding of the study were summarized as following : 1. The rate of bed sore occurrence was 47.4% 2. The areas of bed sore occurrence were hip(28.9%), sacrum(18.6%), great trochanter(14.4%) and the average number of sore spots were 2.26 3. Two groups-one with bed sores and the other without-were studied to determine prediction factors for bed sore risks. Sensory function, humidity, level of activity, mobility, nutrition, skin friction and chapping and body temperature turned out to be statistically significant factors for bed sores. Also the age of clients turned out to be a individual characteristic variable significantly affecting the rate of bed sore occurrences. 4. The education for clients and family on systematic skin assessment and bed sores and practice of active/passive R.O.M. are mainly used as nursing activities for bed sore care. 5. The treatment method varied by stages of bed sores. Sometimes folk remedies like applying the powders of dried elm tree roots to sores were used. Good nutrition, frequent position change and skin care turned to be the most effective means to fast recovery of sores.

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NICU에 입원한 미숙아 어머니의 스트레스 (Study on the Perceived Stress Level of Mothers in Neonatal Intensive Care Unit)

  • 김태임
    • 혜화의학회지
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    • 제8권1호
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    • pp.865-878
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    • 1999
  • With advances in neonatal medicine, smaller and sicker infants are surviving premature birth. As these tiny patients battle for their lives, their parents also struggle with psychological consequences of an unexpected role. The birth of a sick infants has long been documented as stressful events for the parents. High stress levels may alter parents' interaction with their baby and impair their communication with health professionals, which can in turn affect parents' participation in care planning and decision making. Nursing interventions aimed at reducing the parental stress and anxiety levels during this crisis may have a positive impact on their ability to form an attatchment to their baby and make prudent decisions about his care. The planning of such interventions would be inhanced if the contributions of various factors to increased parental stress levels were identified. This descriptive study was conducted to understand the contents and degree of parental stress in the NICU during their premature's hospitalization, and to give a baseline data in developing nursing intervention program. Subjects were the 60 mother of hospitalized newborn in NICU of 2 University Hospital in Taejon City from April 1st, 1999 to June 30th, 1999, who agreed to take part in this study. The instrument used in this study were Parental Stressor Scales:NICU(PSS:NICU) developed by Miles et al.. and validated by 3 NICU practitioners and 3 child health nursing faculties. The questionnaire has 4 dimensions and 45 items; sight and sounds of NICU(5 items), babies' appearance and behavior nursing intervention(19 items), parental role alteration and relationship with their baby(10 items), health team communication(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from "not stressful" (1) to "extremely stressfu1"(5). Total scores representing overall stress from the NICU environment are calculated by summing response to each item. A high score indicates high stress. A subscale score is calculated by summing the responses to each item in the subscale. Cronbach's ${\alpha}$ coefficients were .93. The data was analyzed as average, Frequency, Standard deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study is summarized as follows ; 1. The total perceived stress level score of mothers of premature baby was slightly high($3.66{\pm}1.1$). The highest scored dimension was 'relationship with their baby and parental role change'($4.21{\pm}0.9$), and next were 'appearance and behavior of the baby'($3.92{\pm}1.1$), 'communication with health team'($3.32{\pm}1.3$), 'sight and sounds of NICU'($3.30{\pm}1.1$). 2. There were statistically significant correlation noted ; mother's perceived severity of the baby's condition(F=8.0012, P= .0125) and baby's gestational age(r = -.4724, P = .0500). In summary, information about physical environment of NICU, the mother's perceived severity of premature baby's state, maternal role change related variables and the knowledge of characteristics of premature baby must be included in nursing intervention program of mother's of premature baby in reducing the parental stress and anxiety level. It is suggested that each NICU needs to develop a nurse managed supportive care program for parents of premature baby. Also, it is suggested that there need to investigate the coping mechanism of mother of premature baby.

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보건복지 공무원의 에이즈에 대한 지식과 태도에 대한 연구 (Knowledge and Attitudes about HIV/AIDS among Health Care Officers in S. Korea)

  • Choi, Eun-Jeung;Kim, Wha-Son;Jung, Sun-Bok;Whang, In-Sook;Yang, Jeoung-Nam
    • 보건교육건강증진학회지
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    • 제26권5호
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    • pp.41-55
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    • 2009
  • 목적: 대상자의 에이즈에 대한 지식수준과 태도를 파악하고, 에이즈감염자에 대한 태도에 영향을 미치는 요인을 규명하기 위함이다. 방법: 본 연구는 G광역시내 보건복지 분야에 종사하고 있는 사회복지직과 간호직 공무원을 대상으로 편의 표집 하였다. 자료 수집은 대상자에게 연구목적을 직접 설명한 후 동의를 거쳐 구조화된 설문지에 각자 기입하도록 하였다. 수집된 총 252부의 질문지 중 불성실한 답변을 제외한 245부(사회복지직 124부, 간호직 121부)를 최종분석에 사용하였다. 자료수집은 2008년 12월부터 2009년 1월 사이에 이루어졌다. 측정도구인 에이즈 지식 및 HIV/AIDS 환자(감염인)에 대한 태도 문항은 많은 선행연구에서 인용되고 있는 Herek(2002, 2007)과 Carey & Schroder(2002), 국내 연구 중에는 질병관리본부(2007)의 조사 문항들을 토대로 구성하였다. 결과: 첫째, 대상자의 지식정도의 정답률은 85.9%로 나타났으며 사회복지직 공무원의 지식정도가 간호직보다 낮게 나타났다. 둘째, 통계적으로 유의미 하지 않지만 간호직 공무원의 태도가 사회복지직 보다 에이즈환자에 대해 긍정적 태도를 보여주었다. 셋째, 대상자의 에이즈에 대한 태도는 지식의 정도와 에이즈에 대한 교육경험 유무에 따라 하위영역별로 유의미한 차이가 나타났다. 넷째, 에이즈에 대한 대상자의 태도에 영향을 미치는 요인을 분석한 결과, 대상자의 에이즈에 대한 지식이 가장 큰 영향 요인으로 나타났다. 결론: 에이즈에 대한 임상실천가이면서 정책에 영향을 미치는 사회복지직과 간호직 공무원의 에이즈에 대한 지식을 증진시키고 편견을 감소시키기 위한 실천적 교육 프로그램 개발이 필요하다.

여성건강교육 프로그램 개발에 관한 연구 - 여성건강간호센터에서의 교육을 중심으로 - (Health Educational Program for Women's Health in Women's Health Care Center)

  • 이은희;최상순;소애영
    • 여성건강간호학회지
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    • 제6권1호
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    • pp.67-81
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    • 2000
  • The purpose of this study was to analyze women's health problems using Green & Kreuter's(1991) PRECEDE model and to develop health education program for women's health. The subjects were recruited women from Wonju city 18 years or older. 1. The results showed that about 50% of the women were satisfied with their lives as women, 23% of the sample felt there was a need for a women's health care center. The mean number of health problems was 3.1 and the prevalence rate, 44.4%. 2. We developed on educational program according to group differences related to health problems, diagnosis of disease, variables influencing health promotion behavior, and programs which each group wanted. Also we stressed self-efficacy and self-help group for the management of individual health to all groups. 3. The diagnoses of diseases that were experienced premarital over the past year were gastritis, bronchitis, spinal disk, and fracture, for the childbearing/rearing group, gastritis, vaginitis and cervicitis, cervical cancer and cystitis and nephritis and arthritis and for the middle-aged/elderly group arthritis, gastritis, vaginitis and cervicitis, and spinal disk. Of the sample 30.5% did not have a health exam in the past year, and only 10% of the premarital group, 12.5% of the childbearing/child-rearing group, and 18.3% of the middle aged-elderly group were concerned about their health and did something for their health. 4. The average score on the HPLP was 2.41. the HPLP was scores according to group were found to have significant differences. self-efficacy, family functions, health attention and were considered important variables in the premarital group, in the childbearing/child-rearing group self-efficacy, family functions, internal locus of control, health attention, and health perception and power others locus of control and then for the middle aged-elderly group self-efficacy, health attention, internal locus of control, family functions and health perception. 5. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. The premarital group requested the educational programs on diet, health exercise, family health and stress management. Also the childbearing/child-rearing group wanted programs on diet, family health, stress management, and health exercise, and the middle-aged/elderly group wanted that of family health, diet, climacteric changes stress management and health exercise. The program suggested that this program should be applied to women in the community to insure adequate management of women's health. Follow-up research with PROCEED is needed to analyze health outcomes, also, a women's health nursing specialist system is required to develop health promotion, and improve the quality of life for women.

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임상간호사의 업무의 복잡성, 비판적 사고 성향 및 직관의 관계 (Relationship of Clinical Nurses' Task Complexity, Critical Thinking Disposition and Intuition)

  • 박민경;신화진
    • 한국산학기술학회논문지
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    • 제20권8호
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    • pp.66-74
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    • 2019
  • 본 연구는 임상간호사의 업무의 복잡성, 비판적 사고 성향, 직관 정도를 파악하고 변수들 간의 관련성을 확인하기 위해 시도되었다. 연구대상자는 D시에 소재한 병원, 종합병원 간호사 150명이며, 자료수집 기간은 2017년 6월 15일부터 7월 08일까지였다. 자료분석은 SPSS WIN 24.0을 이용하여 평균, 표준편차, one-way ANOVA, Pearson's correlation coefficients로 분석하였다. 연구결과, 대상자의 업무 복잡성은 $2.33{\pm}.45$, 비판적 사고 성향은 $3.58{\pm}.36$, 직관은 $2.69{\pm}.52$이었다. 대상자의 일반적 특성에 따른 업무 복잡성은 연령(F=4.55, p=.012), 교육수준(F=11.61, p=<.001), 부서(F=26.69, p=<.001), 임상경력(F=4.30, p=.006)에 따라 유의한 차이가 있었다. 비판적 사고 성향은 교육 수준(F=5.25, p=.006), 직위(F=5.35, p=.006)에 따라 유의한 차이가 있었고, 직관은 통계적으로 유의한 차이가 없었다. 업무 복잡성은 비판적 사고 성향(r=.323, p=<.001), 직관(r=.201, p=.013)과 정적 상관관계가 있었으나, 비판적 사고 성향과 직관은 유의한 상관관계가 없는 것으로 나타났다((r=.033, p=.685). 본 연구결과를 통해 간호업무가 복잡하다고 인지하는 간호사를 대상으로 비판적 사고 성향과 직관을 높일 수 있는 교육 및 프로그램의 개발이 필요하다.

Comparing Perceptions, Determinants, and Needs of Patients, Family Members, Nurses, and Physicians When Making Life-Sustaining Treatment Decisions for Patients with Hematologic Malignancies

  • Kim, Semi;Ham, Eun Hye;Kim, Dong Yeon;Jang, Seung Nam;Kim, Min kyeong;Choi, Hyun Ah;Cho, Yun A;Lee, Seung A;Yun, Min Jeong
    • Journal of Hospice and Palliative Care
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    • 제25권1호
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    • pp.12-24
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    • 2022
  • Purpose: This descriptive study compared the perceptions, determinants, and needs of patients, family members, nurses, and physicians regarding life-sustaining treatment decisions for patients with hematologic malignancies in the hematology-oncology department of a tertiary hospital in Seoul, Korea. Methods: In total, 147 subjects were recruited, gave written consent, and provided data by completing a structured questionnaire. Data were analyzed using analysis of variance, the chi-square test, and the Fisher exact test. Results: Nurses (F=3.35) and physicians (F=3.57) showed significantly greater familiarity with the Act on Decisions on Life-Sustaining Treatment than patients (F=2.69) and family members (F=2.59); (F=19.58, P<0.001). Many respondents, including 19 (51.4%) family members, 16 (43.2%) physicians, and 11 (29.7%) nurses, agreed that the patient's opinion had the greatest effect when making life-sustaining treatment decisions. Twelve (33.3%) patients answered that mental, physical, and financial burdens were the most important factors in life-sustaining treatment decisions, and there was a significant difference among the four groups (P<0.001). Twenty-four patients (66.7%), 27 (73.0%) family members, and 21(56.8%) nurses answered that physicians were the most appropriate people to provide information regarding life-sustaining treatment decisions. Unexpectedly, 19 (51.4%) physicians answered that hospice nurse practitioners were the most appropriate people to talk to about life-sustaining treatment (P<0.001). Conclusion: It is of utmost importance that the patient and physician determine when life-sustaining treatment should be withdrawn, with the patient making the ultimate decision. Doctors and nurses have the responsibility to provide detailed information. The goal of end-of-life planning is to ensure patients' dignity and respect their values.