Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
권호 표지

Predictive Factors for City Dwellers' Attitudes toward Death with Dignity

일개 도시주민의 품위 있는 죽음 태도에 대한 예측 요인

  • Jo, Kae Hwa (College of Nursing, Catholic University of Daegu) ;
  • An, Gyeong Ju (Department of Nursing, Cheongju University) ;
  • Kim, Gyun Moo (Department of Emergency Medicine, Catholic University of Daegu School of Medicine) ;
  • Kim, Yeon Ja (Department of Nursing, Taegu Science University)
  • 조계화 (대구가톨릭대학교 간호대학) ;
  • 안경주 (청주대학교 간호학과) ;
  • 김균무 (대구가톨릭대학교 의과대학 응급의학교실) ;
  • 김연자 (대구과학대학교 간호학과)
  • Received : 2012.05.31
  • Accepted : 2012.10.17
  • Published : 2012.12.01
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Abstract

Purpose: This correlation study was performed to examine Korean adults' perceptions and attitudes towards death with dignity and the withdrawal of life sustaining treatment and to identify factors that predict their attitude towards death with dignity. Methods: The study was conducted using convenience sampling of 291 adults from three towns of a metropolitan city in Korea. Data were collected using structured questionnaires which surveyed people's perception about and attitudes towards withdrawal of life sustaining treatment and scaled their attitude towards death with dignity. Data were analyzed by using descriptive statistics, Pearson correlation coefficients and multiple regression. Results: The attitude towards the withdrawal of life sustaining treatment and death with dignity showed a significant positive correlation (r=0.49, P<0.001). For attitudes towards death with dignity, significant predictors were attitudes towards the withdrawal of life sustaining treatment, age, religion, a proper withdrawal process and advanced medical directives, which explained 49.3% of total variance. Conclusion: The results of this study may contribute to development of a new medical decision-making system including nurses' appropriate roles in the process of withdrawing life sustaining treatment and advanced medical directives.

목적: 본 상관관계 연구는 품위 있는 죽음과 연명치료중단에 대한 일개도시 성인 남녀의 인식과 태도를 조사하는 한편, 품위 있는 죽음에 대한 그들의 태도를 예측할 수 있는 요인을 확인하기 위해 시도되었다. 방법: 일개 대도시 중 3개 마을의 성인남녀 총 291명을 편의 표출하였다. 구조화된 설문지 문항에는 연명치료중단에 대한 인식, 연명치료중단에 대한 태도, 품위 있는 죽음 척도에 대한 태도 등을 포함하였다. 자료는 기술통계, 피어슨 상관계수 및 다중회귀분석을 이용하여 분석하였다. 결과: 연명치료중단 및 품위 있는 죽음에 대한 태도는 통계학적으로 유의미한 양의 상관관계(r=0.49, P<0.001)를 보였다. 연명치료중단에 대한 태도, 연령, 종교, 연명치료중단의 적절한 프로세스 및 사전의료의향서(Advanced Medical Directives) 등은 품위 있는 죽음에 대한 태도의 중요한 예측 변수들로, 총 분산의 49.3%를 설명할 수 있었다. 결론: 본 연구 결과는 연명치료중단 및 사전의료의향서 프로세스 상에서 간호사의 적절한 역할 등 새로운 의학적 의사결정 시스템을 개발하는 데에 활용될 수 있다.

Keywords

References

  1. Pullman D. Death, dignity, and moral nonsense. J Palliat Care 2004;20:171-8.
  2. Kim CS. Constitutional law. 18th ed. Seoul:Pakyoungsa;2008.
  3. Kei HY. Constitutional law. 2nd ed. Seoul:Pakyoungsa;2005.
  4. Kwon YS. Constitutional law. Paju:Bobmunsa;2008.
  5. Kwon BG, Kim HC. Bioethics & law. 2nd ed. Seoul:Ewha Womans University Press;2009.
  6. Koh Y. Physician's role and obligation in the withdrawal of life-sustaining management. J Korean Med Assoc 2009;52:871-9. https://doi.org/10.5124/jkma.2009.52.9.871
  7. Jo KH, Kim GM. Understanding the attitude of Korean adults toward dignified dying: Q-methodological approach. Korean J Med Ethics 2011;14:29-43.
  8. Heo DS. Patient autonomy and advance directives in Korea. J Korean Med Assoc 2009;52:865-70. https://doi.org/10.5124/jkma.2009.52.9.865
  9. Byun EK, Choi HR, Choi AL, Kim NM, Hong KH, Kim HS. An investigative research on the attitude of intensive care unit nurses and families on terminating life support. Clinical Nursing Research 2003;9:112-24.
  10. Jo KH. Nurse's conflict experience toward end-of-life medical decision-making. J Korean Acad Adult Nurs 2010;22:488-98.
  11. Jo KH. Development and evaluation of a dignified dying scale for Korean adults. J Korean Acad Nurs 2011;41:313-24. https://doi.org/10.4040/jkan.2011.41.3.313
  12. Lee MY. Attitudes toward life sustaining treatment in Korean adults: an application of Q-methodology [dissertation]. Seoul: Konkuk Univ.; 2010. Korean.
  13. Han SS, Chung SA, Ko GH, Han MH, Moon MS. Nurses' understanding and attitude on DNR. J Korean Acad Nurs Adm 2001;7:403-14.
  14. Korea Institute for Health and Social Affairs. Present social agreement for discontinuance of meaningless prolongation treatment. Seoul;Korea Institute for Health and Social Affairs:2009.
  15. Lee HK, Kang HS. Attitudes and awareness towards the withdrawal of life-sustaining treatment among nurses, physicians, and families of intensive care unit patients. J Korean Clin Nurs Res 2010;16:85-98.
  16. Park KS. The study of consciousness of euthanasia among health professionals: Q-methodological approach [dissertation]. Seoul: Dankook Univ.; 2000. Korean.
  17. Bae JM, Gong JY, Lee JR, Heo DS, Koh Y. A survey of patients who were admitted for life-sustaining therapy in nationwide medical institutions. Korean J Crit Care Med 2010;25:16-20. https://doi.org/10.4266/kjccm.2010.25.1.16
  18. Jo KH, An GJ, Kim GM. Future changes and directions for the construction of medical decision-making system in Korea: focused on delphi surveys. Korean J Med Ethics 2011;14:131-44.
  19. Suh WS, Lee CK. Impact of shared-decision making on patient satisfaction. J Prev Med Public Health 2010;43:26-34. https://doi.org/10.3961/jpmph.2010.43.1.26
  20. Heyland DK, Tranmer J, O'Callaghan CJ, Gafni A. The seriously ill hospitalized patient: Preferred role in end of life decision making? J Crit Care 2003;18:3-10. https://doi.org/10.1053/jcrc.2003.YJCRC2
  21. Briggs L, Colvin E. The nurse's role in end-of-life decision-making for patients and families. Geriatr Nurs 2002;23:302-10. https://doi.org/10.1067/mgn.2002.130271
  22. Lee HJ, Jo KH. A pathmodel for death anxiety to suicidal ideation of the elderly. J Korean Gerontol Soc 2006;26:717-31.
  23. Gauthier DM, Swigart VA. The contextual natural of decision making near the end of life: hospice patients' perspectives. Am J Hosp Palliat Care 2003;20:121-8. https://doi.org/10.1177/104990910302000210
  24. Doorenbos AZ, Wilson SA, Coenen A, Borse NN. Dignified dying: phenomenon and actions among nurses in India. Int Nurs Rev 2006;53:28-33. https://doi.org/10.1111/j.1466-7657.2006.00458.x
  25. Lee YJ. A study on the relationship between elderly consciousness regarding preparation for death and anxiety of death [dissertation]. Seoul: The Catholic Univ.; 2005. Korean.
  26. Chochinov HM. Dying, dignity, and new horizons in palliative end-of-life care. CA Cancer J Clin 2006;56:84-103. https://doi.org/10.3322/canjclin.56.2.84
  27. Lee YJ, Kim SM. Validating the Korean version of the preferences for care near the end-of-life (PCEOL-K) scale. Korean J Med Ethics 2009;12:29-42.
  28. Johnston B, Smith LN. Nurses' and patients' perceptions of expert palliative nursing care. J Adv Nurs 2006;54:700-9. https://doi.org/10.1111/j.1365-2648.2006.03857.x
  29. Cicirelli VG. Personal meanings of death in relation to fear of death. Death Stud 1998;22:713-33. https://doi.org/10.1080/074811898201236
  30. Song T, Kim K, Koh Y. Factors determining the establishment of DNR orders in oncologic patients at a university hospital in Korea. Korean J Med 2008;74:403-10.