• Journal of Hospice and Palliative Care
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• v.24 no.1
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• pp.26-35
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• 2021

Purpose: The purpose of this study was to determine the effects of awareness of good death and end-of-life care attitudes on end-of-life care performance in long-term care hospital nurses. Methods: This study used a cross-sectional study design. The participants were 147 nurses working at six long-term care hospitals with more than 200 beds in B city, South Korea. Data were collected using self-reported questionnaires, and analyzed with descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and multiple stepwise regression analysis using IBM/SPSS 26.0 for Windows. Results: The participants' awareness of good death, end-of-life care attitudes, and end-of-life care performance were positively correlated. The factors affecting end-of-life care performance were age, education level, awareness of good death, and end-of-life care attitudes; these variables explained 19.0% of end-of-life care performance. Conclusion: In order to improve long term care hospital nurses' end-of-life care performance, continuing education and training should be provided regarding awareness of good death and end-of-life care attitudes.

• Journal of Korean Public Health Nursing
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• v.26 no.3
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• pp.572-580
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• 2012

Purpose: This study examined factors influencing death anxiety in the middle aged. Method: This was a descriptive survey study. Data were collected from September to October, 2011, from 410 middle- aged adults. The questionnaires solicited information on death anxiety, health behavior, depression, life satisfaction, and family function. Analysis of data was performed using descriptive statistics, Pearson's correlation, and stepwise multiple regression. Results: Average scores were 2.53 for death anxiety, 3.02 for health behavior, 4.44 for depression, 10.13 for life satisfaction, and 3.77 for family function. Statistically significant negative correlations were observed between health behavior and death anxiety, life satisfaction and death anxiety, and family function and death anxiety. However, from the statistical point of view the correlation between depression and death anxiety was a significantly positive. In addition, statistically significant positive correlations were observed between depression and death anxiety. Depression, life satisfaction, and family function were significant predictors of death anxiety. Conclusion: Multilateral nursing intervention is needed for maintenance of the health of middle aged adults.

• Journal of Hospice and Palliative Care
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• v.26 no.4
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• pp.160-170
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• 2023

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.

• Communications for Statistical Applications and Methods
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• v.26 no.6
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• pp.557-573
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• 2019

Mortality study is an essential component of actuarial risk management for life insurance policies, annuities, and pension plans. Life expectancy has drastically increased over the last several decades; consequently, longevity risk associated with annuity products and pension systems has emerged as a crucial issue. Among the various aspects of mortality study, a consideration of the cause-of-death mortality can provide a more comprehensive understanding of the nature of mortality/longevity risk. In this case study, the cause-of-mortality data in Korea and the US were analyzed along with a multinomial logistic regression model that was constructed to quantify the impact of mortality reduction in a specific cause on actuarial values. The results of analyses imply that mortality improvement due to a specific cause should be carefully monitored and reflected in mortality/longevity risk management. It was also confirmed that multinomial logistic regression model is a useful tool for analyzing cause-of-death mortality for actuarial applications.

• Journal of Hospice and Palliative Care
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• v.24 no.3
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• pp.154-164
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• 2021

Purpose: The purpose of this study was to examine the effects of a death preparation education program for nurses working in convalescent hospitals on death anxiety, death attitudes, and attitudes toward end-of-life care. Methods: This was a quasi-experimental study with a non-equivalent control group, pre-test and post-test design. Among 53 participants, 26 were assigned to the non-equivalent experimental group and 27 to the control group. The program was performed in the formats of lectures, video-watching, group discussions, and sharing, and consisted of 10 sessions held twice a week, for 5 weeks (90 minutes per session). Data were analyzed using descriptive statistics, the t-test, and the chisquare test in SPSS version 21.0. Results: Significant differences between the experimental and control groups were observed in death anxiety (t=7.62, P<0.001), death attitudes (t=-7.58, P<0.001), and attitudes to end-of-life care (t=-10.30, P<0.001). Conclusion: It was confirmed that the death preparation education program reduced death anxiety and had a positive effect on death attitudes and attitudes toward end-of-life care. Based on the results of this study, it is expected that specialized and systematic education that can increase the implementation and stability of death preparation education in various fields, including nursing, will have a positive effect on both hospice patients and members of society more broadly.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.95-100
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• 2023

With the implementation of Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life, interests of the general public on self-determination right and dignified death of patients have increased markedly in Korea. However, "self-determination" on medical care is misunderstood as decision not to sustain life, and "dignified death" as terminating life before suffering from disease in terminal stage. This belief leads that physician-assisted suicide should be accommodated is being proliferated widely in the society even without accepting euthanasia. Artificially terminating the life of a human is an unethical act even though there is any rational or motivation by the person requesting euthanasia, and there is agreement thereof has been reached while there are overseas countries that allow euthanasia. Given the fact that the essence of medical care is to enable the human to live their lives in greater comfort by enhancing their health throughout their lives, physician-assisted suicide should be deemed as one of the means of euthanasia, not as a means of dignified death. Accordingly, institutional organization and improvement of the quality of hospice palliative care to assist the patients suffering from terminal stage or intractable diseases in putting their lives in order and to more comfortably accept the end of life physically, mentally, socially, psychologically and spiritually need to be implemented first to ensure their dignified death.

• The Journal of Korean Academic Society of Nursing Education
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• v.26 no.4
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• pp.383-392
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• 2020

Purpose: This study was a descriptive study to identify factors affecting the attitude toward life-sustaining treatment of nurses working at long-term care hospitals. Methods: Data were collected through structured questionnaires from August 2nd to 27th, 2019. Study participants consisted of 163 nurses who were working for at least 6 months from 7 long-term care hospitals in B and K city. Data were analyzed using t-test, ANOVA, Scheffe' test, Pearson's correlation coefficients, and hierarchical regression with SPSS WIN v 21.0. Results: There were significantly positive correlations between awareness of good death (r=.46, p<.001) and perception of patients' rights (r=.32, p<.001). The factors affecting participants' attitude toward life-sustaining treatment were awareness of good death (β=.35, p<.001) and their own view of death (β=.24, p=.001), which explained about 27.0% of the attitude toward life-sustaining treatment. Conclusion: Based on these results, it is necessary to develop nursing educational materials that can establish values for deaths, and cultivate legal and ethical knowledge related to attitude toward life-sustaining treatment. In addition, since the severity of a patient's condition varies and the characteristics of the institution vary depending on the type of hospital, a study is needed on the relevance of variables considering the hospital environment.

• The Journal of the Korean life insurance medical association
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• v.2 no.1
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• pp.116-121
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• 1985

We've reviewed 518 cases of claims by death that had occured for one year from April, 1983 to March, 1984. As a result, we came to following conclusions; First, the greater part of the death were due to Accidental death(19.1%), Heart disease(18.9%), Malignant neoplasm(17.4%), Liver cirrhosis(10.6%), and the Cerebrovascular disease(9.7%), which were occupied by 75.7% of the whole. Second, classifying them by medical examinations or non medical, death in case of non medical examination showed 89% of the whole. And for age, section ranging from 41 to 50, from 51 to 60 and from 31 to 40 took the overwhelming portion by 27.4%, 26.6%, and 17.4% respectively, those of which showed 71.4% of the whole. Third, for the period elapsed, death within 1 year from the entrance showed 31% and that from 1 year to under 2 years 20.5%. Thus the rate of early death under 2 years stood for 51.5% of the whole.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.5
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• pp.137-144
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• 2019

The purpose of this study is to investigate the relationship between the perception of dying with dignity and the quality of life based on the opinions of the Korean populations. The participants were selected using a stratified proportional allocation method and 1,000 adults aged between 19 and 74 years from 17 municipalities and provinces in Korea. The questionnaire consisted of 2 demographic items; 26 items on the quality of life scale; and 57 items on the perception of dying with dignity. The statistical methods used included frequency analyses, independent sample t-tests, and correlation analyses. The results showed that the quality of life was highest for the social life quality item, and that the participants who had experienced a death in the family were more likely to have statistically lower quality of life in physical, psychological, environmental, and social areas. In terms of the participants' perception on dying with dignity, the score for death preparation was the highest; specifically, the score for psychological/economic burden reduction was the highest. The quality of life of the participants showed a positive correlation in all aspects of the perception of dying with dignity: physical symptoms and control, death preparation, death environment, family and social relations, hospital treatment, psychological dignity, and spirituality. Other studies conducted with middle-aged populations showed that their quality of life was higher when they perceived the acceptance of death is important and were willing to participate in death preparation education. Therefore, in order to improve the quality of life and have a positive influence on the participants, educational programs on death preparation and dying with dignity considering all the areas of the perception of dying with dignity should be provided.

• Journal of Korean Critical Care Nursing
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• v.16 no.3
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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.