• Title, Summary, Keyword: 사전의료의향서

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Effects of Knowledge on Advance Directives and Nursing Professionalism in Nursing Student on Attitudes toward Advance Directives (간호대학생의 사전의료의향서에 대한 지식과 간호전문직관이 사전의료의향서에 대한 태도에 미치는 영향)

  • Jeong, Eun;Jung, Mi-Ra
    • Journal of the Korea Convergence Society
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    • v.10 no.6
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    • pp.337-345
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    • 2019
  • This study were to identify the effect of knowledge on advance directives and nursing professionalism on attitudes toward advance directives in nursing students. The data were collected from 216 nursing students in the two colleges located Jeonnam. The result of the multiple regression indicates the intention to execute advance directives, influence of religion in one's life, knowledge of advance directives, gender, nursing professionalism, and time to complete advance directives predict 22.3%(F=10.009, p=.000) of attitudes toward advance directives. Therefore, it is necessary to develop a program to establish positive attitudes toward advance directives by providing knowledge on advance directives and right nursing professionalism of nursing students.

Convergence Factors Influencing Attitude Toward Advance Directive in Healthcare Workers (의료종사자의 사전의료의향서에 대한 태도에 미치는 융합적 영향요인)

  • Jeong, Eun;Jung, Mi-Ra
    • Journal of Convergence for Information Technology
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    • v.9 no.10
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    • pp.244-253
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    • 2019
  • This study was a descriptive study to investigate the effects of healthcare workers' consciousness of biomedical ethics, recognition of good death, and self-esteem on attitude toward advance directive. Participants in this study were 292 healthcare workers in the three general hospitals located Y city. The data were collected from April 2 to April 23, 2019 and analyzed descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression using the SPSS Win. 22.0 program. The result of the multiple regression indicates the intention to awareness regarding advance directives, intention to execute advance directives, time to complete advance directives and recognition of good death predict 23.5% (F=12.39, P=.000) of attitudes toward advance directives. Therefore, it is necessary to develop a program to establish attitudes toward advance directives by providing education on recognition of good death of healthcare workers.

Awareness of Advance Directives in Gangwon-do Province's adults

  • Hong, Jeongju;Lee, Miok
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.5
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    • pp.169-178
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    • 2020
  • This study was attempted to know the awareness of Advance Directives of adults in Gandwon-do province. Data was surveyed from 60 adults in Gangwon-do province by 42 item questionnaire for the awareness of Advance Directives. Subcategories of Advanced Directives questionnaire were knowledge, preference, experience for life-sustaining treatment and Advance Directives. The data was analyzed with the frequency and percentage using SPSS 24.0. 45% of Participants replied they knew the 'life-sustaining treatment' exactly. They preferred CPR 78.3%, mechanical ventilation 63.3% and blood transfusion 51.7% for their future special life-sustaining treatments. They did not preferred hemodialysis 8.3%, artificial respiration 6.7%, intensive care unit 6.7%, 8.3 percent of participants said that they well aware of Advance Directives. 86.6% of them hoped to write their Advance Directives. Despite such low awareness of the Advance Directives, the intention to write Advance Directives was high. Based on these results, it was found that the level of awareness of Advance Directives was very important for the intention to prepare Advance Directives. Therefore, regional programs and education on Advance Directives and periodic survey study for awareness of Advance Directives should be continued.

Effects of Perception on Hospice, Self-esteem, Knowledge on Advance Directives in Nursing Student on Attitudes toward Advance Directives (간호대학생의 호스피스 인식, 자아존중감, 사전의료의향서에 대한 지식이 사전의료의향서에 대한 태도에 미치는 영향)

  • Jung, Mi-Ra;Jeong, Eun
    • Journal of Digital Convergence
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    • v.17 no.7
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    • pp.255-264
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    • 2019
  • The purpose of this study was to examine relationships among perception on hospice, self-esteem, knowledge on advance directives and attitudes toward advance directives and identify the factors that affect attitudes toward advance directives in nursing students. The data were collected from 216 nursing students in the two colleges located Jeonnam and December 03 2018 to December 07 2018. The data were analyzed by descriptive statistics, t-test, ANOVA, Scheffe, Pearson's correlation coefficient, and multiple regression with SPSS 20.0 program. The result of the multiple regression indicates the perception on hospice, gender, intention to execute advance directives and influence of religion on one's life predict 29.7% (F=12.566, P=.000) of attitudes toward advance directives. Therefore, it is necessary to develop a program to establish attitudes toward advance directives by providing professional education on perception on hospice of nursing students.

Relationship of Knowledge of End-of-life care, Life-Sustaining Treatment, and Advance Directive with the Educational Needs regarding Advance Directives Writing among Nurses in General Hospital in Convergence Era (융합적 시대에서 종합병원 간호사의 임종기 치료, 연명치료, 사전의료의향서에 대한 지식과 사전의료의향서 작성에 대한 교육요구도의 관계)

  • Jeong, Ji-Hyun;Cheon, Jooyoung
    • Journal of The Korea Internet of Things Society
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    • v.6 no.1
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    • pp.45-53
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    • 2020
  • This study aimed to examine the relationship of the knowledge of end-of-life(EOL) care, life-sustaining treatment(LST), and advance directive(AD) with the educational needs regarding AD writing among nurses in convergence era. For this cross-sectional study, participants were 169 nurses at a general hospital in South Korea. Data were collected from July 19 to 26 in 2018 using structured questionnaires. Knowledge on EOL care scored 8.56 out of 11 points, knowledge on LST scored 5.11 out of 6 points, and knowledge on AD scored 8.02 out of 9 points. Educational needs regarding AD writing scored 4.31 out of 5 points. There were statistically correlations between knowledge on LST and educational needs regarding AD writing (r=.182, p=.018), and between knowledge on AD and educational needs regarding advance AD writing (r=.234, p=.002). The findings can be used to develop the educational program regarding AD.

Factors of Family Function and Self-efficasy Influencing Old Patient's Decision of Advance Directives Attitude (노인환자의 사전의료의향서 태도 결정에 영향을 미치는 가족기능과 자기효능감 요인)

  • Kim, Mi-Hye;Chun, Je-Ran;Hong, Seong-Ae
    • Journal of Convergence Society for SMB
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    • v.6 no.4
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    • pp.123-129
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    • 2016
  • This study was conducted to understand influential factors in determining the advance directive attitudes of elderly patients. Structured survey questionnaires were distributed using a convenience sampling method to the residents of long-term-care facilities. As a result, the attitudes toward advance directives were accounted having 2.84 points, the functions of a family with 2.73 points, and the level of self-efficacy with 3.45 points. Participants who have higher family functions were found to have negative attitudes toward self-efficacy, as the relationship between two variables were in the negative correlation (r =-.324, p<.01). However, participants who have higher self-efficacy showed positive attitudes toward advanced directives as the two variables were in the positive correlation (r =.340, p<.01). This study will contribute to the settlement of the AD in Korea.

Development of a Korean Version of an Advance Directive Model via Cognitive Interview (인지면담을 이용한 한국형 사전의료의향서 모델 개발)

  • Kim, Shin Mi;Hong, Young Sun;Hong, Sun Woo;Kim, Jin Shil;Kim, Ki Sook
    • The Korean Journal of Hospice and Palliative Care
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    • v.16 no.1
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    • pp.20-32
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    • 2013
  • Purpose: The purpose of the study was to develop a feasible form of a Korean version of advance directives (K-AD). Methods: Sixteen adults participated in this study: 10 aged 20~50 years and nine aged 65 years or older. Using a draft version of the K-AD, cognitive interview was conducted on the participants to establish a culturally acceptable form of advance directives whose directions can be understood and responded accordingly by the general population. Results: Cognitive interviews revealed areas of concerns for the draft version of K-AD: lack of instructions or clarity for technical and medical terms, context complexity and inadequate response categories. The draft version was revised by rewording, offering examples and rearranging the context. Editorial style was added with appropriate uses of bold fonts, bullet-points and underlines to facilitate interviewees' cognitive responses. Conclusion: Study results feasibility of the revised version of the K-AD. Further study should be performed with a larger number of participants to develop a K-AD with an acceptable level of reliability and validity.

Current Situation on Signing Advance Medical Directives and Actual Life-sustaining Treatment Given at a University Hospital (일개 대학병원의 연명치료 선택 및 사전의료의향서 작성 현황)

  • Yoon, Ho-Min;Choi, Youn-Seon;Hyun, Jong-Jin
    • The Korean Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.91-100
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    • 2011
  • Purpose: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. Methods: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) ${\geq}$10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. Results: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. Conclusion: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.

A Study on the Motivation to Write Signing Advance Medical Directives (사전연명의료의향서 작성 동기에 관한 연구)

  • Chang, Kyung-Hee;Kang, Kyung-hee;Kim, Doo Ree;Lim, HyoNam;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.10
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    • pp.243-249
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    • 2019
  • This study examined the patient's advantage and respect self-decision to protect human dignity and values, who are on the pathway of the hospice palliative care and death process. The study subjects were the elderly who had signed the advance medical directives at C Christian religious facilities in S region. The survey period was started on July 1st, 2019 and lasted for ten days. The study resulted in four topics and eight sub-topics on the motivation for preparing advanced medical directives. The four topics were 'for children', 'fear of pain', 'want to clear my life', 'felt the necessity', and the sub-topics were 'don't want to make a burden to children', 'don't want to make a worry of medical expenses', 'fear of pain', 'have experience of taking caring of painful death process', 'relaxed mind', 'importance of self-decision', 'have known it before but now decided', and 'it is the new information and decided'. This research is meaningful in that it can form the basis for improving well-dying education programs for the good death of the elderly and supplementing effective systems for preparing advance medical directives.

Health Economic Approach to End-of-Life Care in the US: Based on Medicare (말기의료의 경제적 요소에 관한 논의: 미국 메디케어 상황을 중심으로)

  • Suk, Ryan
    • The Korean Society of Law and Medicine
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    • v.15 no.1
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    • pp.335-373
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    • 2014
  • According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

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