임종기 연명치료 중단관련 특성과 사전의료의향서에 대한 노인환자의 태도 = Characteristics of End of Life Sustaining Treatment and Attitudes towards Advance Directives among Geriatric Patients

다국어 초록 (Multilingual 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.

참고문헌 (Reference)

1 이경식, "품위 있는 죽음과 호스피스 완화의료에 대한 일반 국민들의 태도" 한국호스피스완화의료학회 7 (7): 17-28, 2004

2 윤호민, "일개 대학병원의 연명치료 선택 및 사전의료의향서 작성 현황" 한국호스피스완화의료학회 14 (14): 91-100, 2011

3 권복규, "우리나라 일부 병원에서 환자, 보호자, 의료진의 연명치료 중지 관련 의사결정에 관한 태도" 한국의료윤리학회 13 (13): 1-16, 2010

4 김소윤, "연명치료중단과 유보 결정에 대한 한국 중환자 전담의사 인식과 실행" 한국의료윤리학회 12 (12): 15-28, 2009

5 신현호, "삶과 죽음, 권리인가 의무인가?" 한국호스피스완화의료학회 10 (10): 1-20, 2007

6 Lee, H. L., "The older population’s attitudes toward advanced directives among senior center participant in Korea" Seoul National University 2012

7 Detering, K. M., "The impact of advance care planning on end of life care in elderly patients : Randomised controlled trial" 23 : 1136-1345, 2010

8 J. K. Lee, "The Understanding of Terminal Cancer and Its Relationship with Attitudes toward End-of-Life Care Issues" SAGE Publications 34 (34): 720-730, 2014

9 Cohen, J., "Statistical power analysis for the behavioral sciences" Academic Press 1977

10 Statistics Korea, "Population projections for Korea: 2010-2060"

11 Sulmasy, D. P., "Physicians’ confidence in discussing do not resuscitate orders with patients and surrogates" 34 : 96-101, 2008

12 Matsui, M., "Perspectives of elderly people on advance directives in Japan" 39 : 172-176, 2007

13 Ministry of Health & Welfare, "Patient’s self-determination of netting medical, special law enacted recommendations"

14 Nolan, M. T., "Patients’ attitudes toward advance directives and end-of-life treatment decisions" 45 : 204-208, 1997

15 Heo, D. S., "Nursing research of cancer patient and latest knowledge of practice: Cancer patient administration to the patient centered and integrated medical world" 3-12, 2006

16 An, A. R., "Late discussion about end-of-life care in terminal cancer patients : A retrospective cohort study" Seoul University 2012

17 Kim, M. Y., "Korean nurses’ attitude towards Advance Directives and end of life decision making" 3 (3): 77-90, 2010

18 Yu, H. J., "Integrated approach to ethics and law for medical problems : Medical service editorial ethics" Publishing company dongrimsa 2002

19 Pyun, H. J., "Health status, advanced directives among community dwelling elders" Ewha Womans University 2012

20 Special committee of guidelines for decision on life-sustaining treatment, "Guidelines for decision life-sustaining treatment"

21 Alano, G. J., "Factors influencing older adults to complete advance directives" 8 : 267-275, 2010

22 Statistics Korea, "Elderly person Statistics"

23 Bae, J. M,, "Discussion on social consensus regarding institutionalization of with drawing life-sustaining treatments" National Evidence-based Healthcare Collaborating Agency 2009

24 Kang, H. I., "Awareness and experience of nurses and physicians on DNR" 9 : 447-458, 2003

25 Kim, K. S., "Application of Advance Directives at a General Hospital" Ulsan University 2009

26 Heidi, P. C., "Advance directives evaluation of nurses’ knowledge, attitude, confidence, and experience" 24 (24): 250-256, 2009

27 Ware, J. E., "A 12-item short-form health survey : Construction of scales and preliminary reliability and validity" 34 : 220-233, 1996