Journal of East-West Nursing Research (동서간호학연구지)

East-west Nursing Research Institute, Kyung Hee University (경희대학교 동서간호학연구소)
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Characteristics of End of Life Sustaining Treatment and Attitudes towards Advance Directives among Geriatric Patients

임종기 연명치료 중단관련 특성과 사전의료의향서에 대한 노인환자의 태도

  • Received : 2014.06.02
  • Accepted : 2014.09.22
  • Published : 2014.11.30
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Abstract

Purpose: The purpose of this study was to identify the characteristics of life-sustaining treatment and attitudes towards advance directives among geriatric patients. Methods: The elderly participants (N=146) were recruited from a university hospital from October 30, 2012 to March 31, 2013. A questionnaire for collecting data of participants' characteristics, their experiences related to life-sustaining treatment, and attitudes towards advance directives was used. The data were analyzed using SPSS WIN 17. Results: Most participants (84.9%) were in favor of advance directives. Although most of participants wanted to receive CPR for sudden cardiac arrest (78.8%) and pain control medication (74.0%), most preferred to refuse life-sustaining treatments such as tracheostomy (96.6%) or ventilator (87.0%). Participants who had a family or acquaintances with CPR experiences (U=852.00 p=.038), had discussed with their family and acquaintances regarding end-of-life sustaining treatment (t=2.91, p=.004), or made decisions about refusing the life sustaining treatments (t=3.19, p=.002) preferred to have advance directives than those who did not. Conclusion: The findings of this study suggested the potential benefits of educational programs about advance directives for the end-of-life for geriatric patients to make decisions for life-sustaining treatments in advance.

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References

  1. Alano, G. J., Pekmezaris, R., Tai, J. Y., Hussain, M. J., Jeune, J., Louis, B., et al. (2010). Factors influencing older adults to complete advance directives. Palliative Support Care, 8, 267-275 https://doi.org/10.1017/S1478951510000064
  2. An, A. R. (2012). Late discussion about end-of-life care in terminal cancer patients : A retrospective cohort study. Unpublished master's thesis, Seoul University, Seoul.
  3. Bae, J. M, (2009, October.). Discussion on social consensus regarding institutionalization of with drawing life-sustaining treatments. National Evidence-based Healthcare Collaborating Agency, Seoul.
  4. Cohen, J. (1977). Statistical power analysis for the behavioral sciences. New York, NY: Academic Press.
  5. Detering, K. M., Hancock, A. D., Reade, M. C., & Silvester, W. (2010). The impact of advance care planning on end of life care in elderly patients: Randomised controlled trial. British Medical Journal, 23, 1136-1345.
  6. Heidi, P. C., Cindy, D., Samantha, R., & Kimberly, M. (2009). Advance directives evaluation of nurses' knowledge, attitude, confidence, and experience. Journal of Nursing Care Quality, 24(3), 250-256. https://doi.org/10.1097/NCQ.0b013e318194fd69
  7. Heo, D. S. (2006). Nursing research of cancer patient and latest knowledge of practice: Cancer patient administration to the patient centered and integrated medical world. Proceedings of the Research Institute of Nursing Science at College of Nursing, Seoul National University, South Korea, 2006, 3-12.
  8. Kang, H. I., & Yom, Y. H. (2009). Awareness and experience of nurses and physicians on DNR. Journal of Korean Academy of Nursing Administration, 9, 447-458.
  9. Kim, K. S. (2009). Application of Advance Directives at a General Hospital. Unpublished master's thesis, Ulsan University, Ulsan.
  10. Kim, M. Y., & Kim, K. S. (2010). Korean nurses' attitude towards Advance Directives and end of life decision making. Journal of Korean Critical Care Nursing, 3(2), 77-90.
  11. Kim, S. Y., Kang, H. H., Koh, Y. S., & Koh, S. O. (2009). Attitudes and practices of critical care physicians in end-of-life decisions in Korean intensive care units. Korean Journal of Medical Ethics, 12, 15-28.
  12. Kwon, I., Koh, Y. S., Yun, Y. H., Heo, D. S., Seo, S. Y., Kim, H. C., et al. (2010). A study of the attitudes of patients, family members, and physicians toward the withdrawal of medical treatment for terminal patients in Korea. Korean Journal of Medicine Ethics, 13, 1-16.
  13. Lee, H. L. (2012). The older population's attitudes toward advanced directives among senior center participant in Korea. Unpublished master's thesis, Seoul National University, Seoul.
  14. Lee, J. K., Yun, Y. H., An, A. R., Heo, D. S., Park, B. W., Cho, C. H., et al. (2013). The understanding of terminal cancer and its relationship with attitudes toward end-of-life care issues. Medical Decision Making. Advance online publication. DOI: 10.1177/0272989X13501883
  15. Matsui, M. (2007). Perspectives of elderly people on advance directives in Japan. Journal of Nursing Scholarship, 39, 172-176. https://doi.org/10.1111/j.1547-5069.2007.00163.x
  16. Ministry of Health & Welfare. (2013, July 31). Patient's self-determination of netting medical, special law enacted recommendations. Retrieved July 31, 2013, from http://www.mw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=288993&page=1
  17. Nolan, M. T., & Bruder, M. (1997). Patients' attitudes toward advance directives and end-of-life treatment decisions. Nursing Outlook, 45, 204-208. https://doi.org/10.1016/S0029-6554(97)90066-X
  18. Pyun, H. J. (2012). Health status, advanced directives among community dwelling elders. Unpublished master's thesis, Ewha Womans University, Seoul.
  19. Shin, H. H. (2007). Life & Death, Right or Duty? The Legal Study of Hospice and Palliative Care, 10, 1-20.
  20. Special committee of guidelines for decision on life-sustaining treatment. (2013, September). Guidelines for decision life-sustaining treatment. Retrieved January 30, 2013, from http://endocrinology.or.kr/bbs/index.html?code=notice2&mode=view&number=538
  21. Statistics Korea. (2011, December). Population projections for Korea: 2010-2060. Retrieved April 18, 2014, from http://kostat.go.kr/portal/english/news/1/17/1/index.board?bmode=download&bSeq=&aSeq=273109&ord=2
  22. Statistics Korea. (2013, September). Elderly person Statistics. Retrieved September 30, from http://kostat.go.kr/portal/korea/kor_nw/2/1/index.board?bmode=read&aSeq=308688
  23. Sulmasy, D. P., Sood, J. R., & Ury, W. A. (2008). Physicians' confidence in discussing do not resuscitate orders with patients and surrogates. Journal of Medicine Ethics, 34, 96-101. https://doi.org/10.1136/jme.2006.019323
  24. Ware, J. E., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary reliability and validity. Medical Care, 34, 220-233. https://doi.org/10.1097/00005650-199603000-00003
  25. Yoon, H. M., Choi, Y. S., & Hyun, J. J. (2011). Current situation on signing advance medical directives and actual life-sustaining treatment given at a university hospital. Korean Journal of Hospice and Palliative Care, 14, 91-100.
  26. Yu, H. J., Son, M. S., & Lee, K. H. (2002). Integrated approach to ethics and law for medical problems: Medical service editorial ethics. Seoul: Publishing company dongrimsa.
  27. Yun, Y. H., Rhee, Y. S., Nam, S. Y., Chae, Y. M., Heo, D. S., Lee, S. W., et al. (2004). Public attitudes toward dying with dignity and hospice. The Korean Journal of Hospice and Palliative care, 7, 17-28.

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