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The effects of death orientation and attitude toward withdrawal of life-sustaining treatment on awareness of biomedical ethics among paramedic students

  • Park, Yunhee (Dept. of Nursing, Wonkwang University) ;
  • Song, Hyo-Suk (Dept. of Emergency Medical Technology, Daejeon Health Institute of Technology)
  • Received : 2020.01.30
  • Accepted : 2020.02.23
  • Published : 2020.02.28

Abstract

This study was conducted to identify the effects of the degree of death orientation, attitudes toward withdrawing life-sustaining treatment, and awareness of biomedical ethics on paramedic students' own biomedical ethics. The participants of this study were 228 paramedic students from a college located in D city. Data were collected from April to June 2019 through a self-report questionnaire. There was a positive correlation between awareness of biomedical ethics and attitude toward withdrawing life-sustaining treatment (r=.63, p<.001). Multiple linear regression analysis showed that the factors affecting students' awareness of biomedical ethics were religion (β=.12, p=.018) and their attitude toward withdrawal of life-sustaining treatment (β=.61, p<.001), with an explanatory power of 41.0%. Educational programs must focus on attitudes toward withdrawing life-sustaining treatment to improve paramedic students' awareness of biomedical ethics.

본 연구는 응급구조과 대학생의 죽음의식, 연명치료중단에 대한 태도, 생명의료윤리인식의 수준을 파악하고, 생명의료윤리인식에 영향을 미치는 요인을 확인하기 위해 시도되었다. 연구대상은 D시에 소재한 일개대학 응급구조과 재학생 228명을 대상으로 시행하였으며, 자료수집은 2019년 4월부터 6월까지 자기보고식 구조화된 설문지를 이용하였다. 연구결과로 생명의료윤리인식과 연명치료중단에 대한 태도 간에는 정적 상관관계가 있는 것으로 분석되었다(r=.63, p<.001). 다중회귀분석결과, 생명의료윤리인식에 영향을 미치는 요인은 종교(β=.12)와 연명치료중단에 대한 태도(β=.61)로 41.0%의 설명력을 나타냈다. 따라서 생명의료윤리인식을 향상시키기 위해 응급구조과 학생들의 교육프로그램은 연명치료중단에 대한 태도에 초점을 맞추어야 할 것이다.

Keywords

References

  1. B. Steer, “Paramedics, consent and refusal–are we competent?,” Australasian Journal of Paramedicine, Vol. 5, No. 1, pp. 219-232, 2015. https://doi.org/10.33151/ajp.5.1.404
  2. B. Lord, K. Recoche, M. O'Connor, and P. Yates, "Service M. Paramedics' perceptions of their role in palliative care: analysis of focus group transcripts," Journal of palliative care, Vol. 28, No. 1, pp. 36-40, 2012. https://doi.org/10.1177/082585971202800106
  3. T. Johnston, and J. Acker, "Using a sociological approach to answering questions about paramedic professionalism and identity," Australasian Journal of Paramedicine, Vol. 13, No. 1, pp.1-7, 2016.
  4. H. W. Yun, and J. M. Lee, “Perceptions about the professional ethics of EMT,” Fire Science and Engineering, Vol. 28, No. 1, pp. 71-78, 2014. https://doi.org/10.7731/KIFSE.2014.28.1.071
  5. S. H. Kim, and M. Lee, “The influence of moral sensitivity of emergency medical technology students on biomedical ethics,” Journal of Multimedia Services Convergent with Art, Humanities, and Sociology, Vol. 7, No. 3, pp. 757-764, 2017.
  6. L. Holmes, R. Jones, R. Brightwell, and L. Cohen, "Student paramedic anticipation, confidence and fears: Do undergraduate courses prepare student paramedics for the mental health challenges of the profession?," Australasian Journal of Paramedicine, Vol. 14, No. 4, 2017.
  7. C. Park, "The meaning of death" Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology. Vol. 8, No. 5, pp. 589-597, 2018.
  8. G. S. Park, "Sense Researches of Medical Agent over Euthanasia of Patients Who Can't Resuscitate: Q-methodological Approch," Unpublished master's thesis. University of Dankook, Chunan, 2000.
  9. Y. M. Seo, and S. J. Shin, "The relationship among attitude toward the withdrawal of life-sustaining treatment, death anxiety, and death acceptance among hospitalized elderly cancer patients" Asian Oncology Nursing, Vol. 19, No. 3, pp. 142-149, 2019. https://doi.org/10.5388/aon.2019.19.3.142
  10. E. J. Choi, and H. S. Jeong, "The effect of nursing students' consciousness of biomedical ethics, good death recognition, and self-esteem on the attitude toward withdrawal of life-sustaining treatment" Journal of the Korea Academia-Industrial cooperation Society, Vol. 19, No. 5, pp. 275-284, 2018. https://doi.org/10.5762/KAIS.2018.19.5.275
  11. M. Y. Moon, M. K. Jeon, and A. H. Jaung, "Relationship between Nurses Consciousness of Biomedical ethics, Job satisfaction and nursing performance" Journal of the Korean Bioethics Association, Vol. 14, No. 1, pp. 27-47, 2013.
  12. Y. M. Koo, "Biomedical Ethics," 3st ed, Dongnyok, 2010.
  13. D. Templer, "The construction and validation of a death anxiety scale" Journal of General psychology, Vol. 82, pp. 165-177, 1970. https://doi.org/10.1080/00221309.1970.9920634
  14. J. I. Boyar, "The construction and partial validation of a scale for the measurement of the fear of death" Unpublished doctoral dissertation, University of Rochester, 1964.
  15. J. A. Thorson, and F. C. Powell, "Elements of Death Anxiety and Meaning of Death" Journal of Clinical Psychology, Vol. 44, No. 5, pp. 691-701, 1988. https://doi.org/10.1002/1097-4679(198809)44:5<691::AID-JCLP2270440505>3.0.CO;2-D
  16. S. C. Park, "A study on the death orientation of hospice volunteers", J of Korean Academy of Nursing, Vol. 22, No. 1, pp. 68-80, 1992.
  17. E. K. Byun, H. R. Choi HR, Choi AL, Hong KH, Kim NM, Kim HS. "An Investigative Research on The Attitude of Intensive Care Unit Nurses and Families on Terminating Life Support", Clinical Nursing Research, Vol. 9, No. 1, pp. 112-124, 2003.
  18. Y. S. Lee, "A study of the ethical values of Korean nurses", J Nurs Acad Soc, Vol. 20, pp. 249-270, 1990. https://doi.org/10.4040/jnas.1990.20.2.249
  19. S. J. Kwon, "A study on the consciousness of biomedical ethics of the nursing students and medical students", Unpublished master's thesis, University of Keimyung, Deagu, 2003.
  20. Y. J. Lee, I. O. Moon, "Development and testing of the Short Form Biomedical Ethics Scale", Global Health & Nursing, Vol. 5, No. 2, pp. 67-77, 2015.
  21. K. S. Kang, "A Study on the Nursing Student's Attitude om Death Hospice", Chonnam Journal of Nursing Sciences, Vol. 5, No. 1, pp. 187-201, 2000.
  22. Z. S. Lee, "The Death Orientation of Nursing Students in Korea and China", Unpublished master's thesis, Ewha Womans University, Seoul, 2007.
  23. S. H. Kim, M. H. Lee, "The influence of moral sensitivity of emergency medical technology students on biomedical ethics", Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology, Vol. 7, No. 3, pp. 757-764, 2017.
  24. M. L. Olsen, K. M. Swetz, P. S. Mueller, "Ethical decision making with end-of-life care: palliative sedation and withholding or withdrawing life-sustaining treatments", In Mayo Clinic Proceedings, Vol. 85, No. 10, pp. 949-954, 2010.
  25. S. N. Kim, H. J. Kim, "Recognition of good death, attitude towards the withdrawal of life-sustaining treatment, and attitude towards euthanasia in nurses", The Korean Journal of Hospice and Palliative Care, Vol. 19, No. 2, pp. 136-144, 2016. https://doi.org/10.14475/kjhpc.2016.19.2.136
  26. C. Y. Chang, Y. S. Kim, "Attitude toward forgoing life-sustaining treatment among cancer patient families", Ment Health Soc Work, Vol. 38, pp. 5-30, 2011.
  27. H. S. Kim, S. R. Shin, "The Influence of Social Support among Community Dwelling Elderly and their Attitude towards the Withdrawal of Life-sustaining Treatment: A Mediating Effect of Self-esteem", Korean Journal of Adult Nursing, Vol. 29, No. 4, pp. 373-381, 2017. https://doi.org/10.7475/kjan.2017.29.4.373
  28. Y. M. Jang, E. Ahn, "The Effects of Moral Sensitivity, Biomedical Ethics Awareness on Attitudes toward Withdrawal of Life-Sustaining Treatment of Nursing Students", Journal of Industrial Convergence, Vol. 17, No. 2, pp. 53-61, 2019. https://doi.org/10.22678/JIC.2018.17.2.053