The Journal of Korean Medicine (대한한의학회지)

The Society of Korean Medicine (대한한의학회)
권호 표지
DOI QR코드

DOI QR Code

The Characteristics of the Subject and Relationship between the Intention to Use Hospice and Allowance of Pre-accession based on the Advance Directives Registered by Korean Medicine Clinic

한의원에서 등록된 사전연명의료의향서를 기반으로 대상자의 특성과 호스피스 이용의향 및 사전열람 허용여부와의 관계

  • Hae-chang Yoon (Haechang Korean medicine clinic) ;
  • Junghyo Cho (East-West Cancer Center of Daejeon Hospital, Daejeon University)
  • 윤해창 (해창한의원) ;
  • 조정효 (대전대학교 대전한방병원 동서암센터)
  • Received : 2024.05.24
  • Accepted : 2024.08.19
  • Published : 2024.09.01
Download PDF
⟨ Previous Next ⟩

Abstract

Background: In the Republic of Korea, the implementation of the Life-Sustaining Treatment Decision System has facilitated end-of-life care planning through advanced directives. Despite the availability of this system, there are few studies about advance directives itself and Korean medicine clinics(KMC) have been underrepresented as registration institutions, with limited data on their involvement. Objective: The study delved into the landscape of advance directives within KMC, shedding light on the characteristics of the subject and the correlation between sociodemographic factors with the intention to use hospice and the allowance of pre-access. Results: Data from a specific KMC's advance directives registry were analyzed, with 89 cases meeting the criteria for investigation. Results revealed a predominant female presence among registrants, with an average age of 70.28 ± 9.47 years. While no statistically significant relationship was found between gender/age/distance and the intention to use hospice or pre-access allowance, those expressing a desire for hospice care were more inclined to permit pre-access. In addition, the closer the distance, the older the subject. These findings underscore the evolving dynamics of end-of-life care planning in Korea, urging greater participation of KMC in hospice palliative care initiatives. The study's limitations include its single-institution focus and potential impact from the COVID-19 pandemic. Conclusion: The study found a strong link between hospice intention and pre-access allowance and highlighted the association between distance and age. These findings emphasized the evolving role of KMC in end-of-life care planning and call for further research to explore their increasing involvement in hospice palliative care initiatives.

Keywords

References

  1. Korean Law Information Center. Act on Hospice ad Palliative care and Decisions on Life-sustaining Treatment for Patients at the End of Life. [cited 2024 April 19]; Available from: URL:https://www.law.go.kr/lsSc.do?section=&menuId=1&subMenuId=15&tabMenuId=81&eventGubun=060101&query=%EC%97%B0%EB%AA%85%EC%9D%98%EB%A3%8C#undefined 
  2. National Agency for Management of Life-sustaining Treatment. Monthly statistics. [cited 2024 April 19]; Available from: URL:https://www.lst.go.kr/comm/monthlyStatistics.do 
  3. Korean Statistical Information Service. Estimated population by major age groups. [cited 2024 April 19]; Available from: URL:https://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1BPA003&vw_cd=MT_ZTITLE&list_id=&scrId=&seqNo=&lang_mode=ko&obj_var_id=&itm_id=&conn_path=E1&docId=0268536731&markType=S&itmNm=%EC%A0%84%EA%B5%AD 
  4. Korean Statistical Information Service. Survey on the Status of the Elderly. [cited 2024 April 19]; Available from: URL:https://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117071_075&vw_cd=MT_ZTITLE&list_id=117_11771_003_04&scrId=&seqNo=&lang_mode=ko&obj_var_id=&itm_id=&conn_path=MT_ZTITLE&path=%252FstatisticsList%252FstatisticsListIndex.do 
  5. National Agency for Management of Life-sustaining Treatment. Monthly statistics. [cited 2024 July 16]; Available from: URL: https://www.lst.go.kr/addt/composableorgan.do 
  6. Kim, M.S., Gang, M.H., & Kim, Y.O. (2018). Completion and related factors of advance directives in old adults. J Korea Contents Assoc, 18(2), 240-247. https://doi.org/10.5392/JKCA.2018.18.02.240 
  7. Lim, J.M., & Kim, B.J. (2021). Intentions of signing advance directives among Koreans aged 65 and older, with policy implications. J Human Soc Sci, 12(2), 2733-2744. http://doi.org/10.22143/HSS21.12.2.192 
  8. Park, N.J., Hong, S.A., & Song, I.M. (2021). Factors affecting intention to complete advance directives in older Koreans. Korean Public Health Res, 47(1), 47-57. https://doi.org/10.22900/kphr.2021.47.1.005 
  9. Park, J.K. (2023). Factors Affecting the Preparation of Advance Directives of Older People. J Korean Soc Integr Med, 11(2), 87-99. https://doi.org/10.15268/ksim.2023.11.2.087 
  10. Yeom, E.Y., & Seo, K.S. (2019). Influence of older person's ego integrity and knowledge of advance directives on their attitude toward withdrawal from life-sustaining treatment. J Korean Gerontol Nurs, 21(3), 173-182. https://doi.org/10.17079/jkgn.2019.21.3.173 
  11. Cheon, J.Y. (2020). Completion of Advance Directive and Withdrawal of Life-sustaining Treatments among Older Adults in South Korea: A Systematic Review. Korean Soc Living Environmental System, 27(4), 473-488. http://doi.org/10.21086/ksles.2020.08.27.4.473 
  12. Ryu, M.H. (2022). Public knowledge and attitude towards advance directives and their intention towards withdrawing life-sustaining treatment. J Korea Acad-Ind Coop Soc, 23(7), 297-307. http://doi.org/10.5762/KAIS.2022.23.7.297 
  13. Han, H.K., Oh, C.S., Ryu, J.S., & Lim, B.M. (2014). Comparison of Patients' Satisfactions with General Korean Medicine Clinics and Networked Korean Medicine Clinics in Seoul, Korea. J Soc Prevent Korean Med, 18(3), 57-67. https://koreascience.kr/article/JAKO201403760396372.page 
  14. Hwang, J.W., & Park, J.S. (2015). Analysis of the Use of Oriental Medicine Outpatient Services and the Characteristics of Users. Kor Health Ind Dev Inst Brief, 175, 1-8. https://www.khidi.or.kr/fileDownload?titleId=129478&fileId=1&fileDownType=C¶mMenuId=MENU01783
  15. Lim, J.W., & Lee, K.J. (2021). Influencing factors of using Korean Medicine services - focusing on the 2017 Korean Medicine Utilization Survey. J Korean Med, 42(1), 12-25. http://doi.org/10.13048/jkm.21002 
  16. Choi, S.Y., Shin, H.K., Park, H.M. & Lee, S.D. (2012). A Analysis of Patients Using Korean Medicine Clinics. - Analysis of Outpatients and Inpatients by Age, Sex and Regions -. Kor J Oriental Prevent Med Soc, 16(2), 67-81. https://koreascience.kr/article/JAKO201232736361686.page 
  17. Massimo, A., Claudia, B., Cinzia, D.G., Fabio, F., & Luigi, C. (2015). Distance as a Barrier to Cancer Diagnosis and Treatment: Review of the Literature. The Oncologist, 20, 12, 1378-1385, https://doi.org/10.1634/theoncologist.2015-0110 
  18. Lin, C.C., Hill, C.E., Kerber, K.A., Burke, J.F., Skolarus, L.E., Esper, G.J., de Havenon, A., De Lott, L.B., & Callaghan, B.C. (2023). Patient Travel Distance to Neurologist Visits. Neurology, 101, 18, e1807-e1820. https://doi.org/10.1212/WNL.0000000000207810 
  19. Central Hospice Center. (2023). 2022 National Hospice Palliative Care Annual Report. Korean Ministry of Health and Welfare. https://hospice.go.kr:8444/index.html?menuno=22&bbsno=407&boardno=9&ztag=rO0ABXQANzxjYWxsIHR5cGU9ImJvYXJkIiBubz0iOSIgc2tpbj0iaG9zcGljZV9ub3JtYWwiPjwvY2FsbD4%3D&siteno=1&act=view 
  20. Korean Ministry of Health and Welfare. (2024). Comprehensive Plan for Life-sustaining Treatment of Hospice (2024~2028). Seoul; Republic of Korea. https://www.mohw.go.kr/boardDownload.es?bid=0008&list_no=1480964&seq=1 
  21. Yoon, H.C., Son, C.G., Lee, N.H., & Cho, J.H. (2018). Study of the Developmental History on Hospice⋅Palliative Care and Need for Korean Medicine. Journal of Internal Korean Medicine, 39(4), 662-675. https://doi.org/10.22246/jikm.2018.39.4.662 
  22. Rogers, J., Goldsmith, C., Sinclair, C., & Auret, K. (2019). The advance care planning nurse facilitator: describing the role and identifying factors associated with successful implementation. Aust J Prim Health, 25, 6, 564-569. https://doi.org/10.1071/PY19010 
  23. Bioethics Policy Research Center. (2011). Report for Suspension of Life-sustaining Treatment and Pre-medical Intentions. Medical Ethics Policy Research Report. http://www.nibp.kr/xe/?module=file&act=procFileDownload&file_srl=9294&sid=fa25ade0907ba00d7c9581befe272f69 
  24. Heo, D.S. (2009). Patient Autonomy and Advance Directives in Korea. J Korean Med Assoc; 52(9): 865-870. http://doi.org/10.5124/jkma.2009.52.9.865 
  25. Song, T.J., Kim, K.P., & Koh, Y. (2008). Factors determining the establishment of DNR orders in oncologic patients at a university hospital in Korea. Korean J Med, 74, 403-410. https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART001240891 
  26. Shim, B.Y., Hong, S.I., Park, J.M., Cho, H.J., Ok, J.S., Kim, S.Y., …, & Kim, H.K. (2004). DNR Order for Terminal Cancer Patients at Hospice Ward. Korean J Hosp Palliat Care, 7, 232-237. https://koreascience.kr/article/JAKO200423514844425.page 
  27. Oh, D.Y., Kim, J.H., Kim, D.W., Im, S.A., Kim, T.Y., Heo, D.S., …, & Kim, N.K. (2006). CPR or DNR? End-of-life decision in Korean cancer patients: a single center's experience. Support Care Cancer, 14, 103-108. https://doi.org/10.1007/s00520-005-0885-5 
  28. Hickman, Jr R.L., Daly, B.J., Lee E.S. (2012). Decisional conflict and regret: consequences of surrogate decision making for the chronically critically ill. Appl Nurs Res, 25(4), 271-5. https://doi.org/10.1016/j.apnr.2011.03.003 
  29. Chang, W.K., Ahn, K.J., Kim, M.Y., Kim, Y.R., & Han, Y.J. (2015). The role of a patient's family when the withdrawal of life-sustaining treatment is expected: A narrative analysis. Korean J Med Ethics, 18(2), 172-189. https://doi.org/10.35301/ksme.2015.18. 2.172