Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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The Effect of Cancer Patients' Knowledge of Advanced Directives and Perception of Good Death on Attitude toward Withdrawal of Life-Sustaining Treatment

암환자의 사전연명의료의향서 지식과 좋은 죽음 인식이 연명의료중단 태도에 미치는 영향

  • Park, Sang-Un (Gyeongsang National University Hospital) ;
  • Kang, Yong-Sil (College of Nursing, Institute of Health Sciences, Gyeongsang National University)
  • 박상언 (경상대학교병원) ;
  • 강영실 (경상대학교 간호대학, 경상대학교 건강과학연구원)
  • Received : 2020.10.23
  • Accepted : 2021.02.05
  • Published : 2021.02.28
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Abstract

This study was conducted to identify the effects of knowledge of Advance Directives (AD) and the patient's perception of a peaceful death on their attitude toward the withdrawal of life-sustaining treatment and to provide basic data for the development of a nursing intervention program for activating self-determination in the withdrawal of life-sustaining support of patients. The subjects were 167 adult cancer patients who received outpatient or inpatient treatment, from September 15, 2019, to March 30, 2020. The data was analyzed by mean, standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression by using SPSS 21.0. From the results, it was observed that the knowledge of AD was 8.87±2.46 out of 12, perception of a peaceful death was 2.87±0.42 out of 4, and attitude toward withdrawal of life-sustaining treatment was 3.46±0.49 out of 5. There was a positive correlation between knowledge of AD, perception of a peaceful death, and their attitude toward withdrawal of life-sustaining treatment. The influencing variables were the knowledge of AD, perception of a peaceful death, discussion with family on withdrawal of life-sustaining treatment, and explanation power was 16.0% (F=10.355, p<.001). Therefore, it is necessary to develop a program that would improve the perception of a peaceful death, increase the knowledge of AD to improve the patients' attitude toward the withdrawal of life-sustaining treatment. An intervention to assist a discussion between the patients and their families in advance would also be useful.

본 연구는 암환자의 사전연명의료의향서 지식, 좋은 죽음 인식이 연명의료중단 태도에 미치는 영향을 파악하여 암환자의 연명의료중단의 자기결정 활성화를 위한 간호 중재프로그램 개발 기초 자료를 제공하고자 시행되었다. 외래 또는 입원치료를 받는 성인 암환자 167명을 대상으로, 2019년 9월 15일부터 2020년 3월 30일까지 자료수집을 하였다. 수집된 자료의 통계분석은 SPSS 21.0을 이용하여 평균과 표준편차, t-test, ANOVA, Pearson 상관계수, 다중회귀분석으로 하였다. 연구결과, 대상자의 사전연명의료의향서 지식은 1점 만점에 0.74±0.21점, 좋은 죽음 인식은 4점 만점에 2.87±0.42점, 연명의료중단 태도는 5점 만점에 3.46±0.49점이었다. 본 연구결과 연명의료중단 태도는 사전연명의료의향서 지식, 좋은 죽음 인식과 정적 상관관계로 나타났으며, 영향을 미치는 변인은 사전연명의료의향서 지식, 좋은 죽음인식, 가족과 연명의료중단 논의 여부로 나타났고, 설명력은 16.0%이었다(F=10.355, p<.001). 따라서, 암환자의 연명의료중단 태도 향상을 위해 사전연명의료의향서 지식 및 좋은 죽음 인식을 높일 수 있는 프로그램 개발이 필요하며, 가족과 환자의 사전 논의에 도움을 줄 수 있는 중재 방안이 필요하다.

Keywords

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