• Journal of Hospice and Palliative Care
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• v.14 no.2
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• pp.81-90
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• 2011

Purpose: This study is to understand how community members perceive past life recollection and preparation for death. Methods: Using a questionnaire, we surveyed 160 adult residents of one of the districts (gu) in Seoul, Korea. Descriptive statistics were used. Results: Participants chose their 30s and 40s as the most difficult time in their lives. The most painful experience was "an illness of a family member", followed by "trouble with a spouse", and "trouble with children". As for the most difficult social experience, "sense of loss in life" was ranked the highest. Personally, the happiest time was "accomplishment of a goal", while it was "happiness through children" in family relationship and "contribution to society through my career" in social life. As for the most regrettable experience, personally "having lived without purpose" was the highest, "not meeting my parents' expectation more" in family relationship; "not providing sufficient education" in relationship with children; "not having an occupation that I wanted" in work life, and "lack of social skills" in social life. More than 87% of the surveyed showed a positive attitude about the system of the do not resuscitate (DNS) order. For a situation where participants were supposed to have an incurable disease, "I want to be notified of the true condition" and "I want to write a will and advanced directives" ranked high, receiving more than 3.1 points out of 4. Conclusion: These results demonstrate the need for death education to provide people with an opportunity to accept their regrettable experiences in the past as part of their life. Also, this study suggests the importance of writing advanced directives for people to prepare for "death with dignity" how it can help their decision to be better respected.

• The Journal of Korean Society for School & Community Health Education
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• v.22 no.1
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• pp.55-72
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• 2021

Objectives: The aim of this study was to construct and verify a structural equation model of advance directive intent among a Korean group in their middle-age. Methods: Data were collected between May 1 and 30, 2017, from 398 people. The endogenous and exogenous variables of the hypothetical model consisted of elderly parents' care burden, health status, attitude towards withdrawal of life sustaining treatment, advance directive efficacy, and advance directive intent. The collected data were analyzed using the SPSS/WIN 24.0 and Mplus 7.4. Results: The hypothetical model demonstrated a good fit: χ2=223.79(df=109, p<.001), CMIN/df=2.05 CFI=.96, TLI=.96, RMSEA=.05, SRMR=.06. Elderly parents' care burden and health status showed statistically significant direct effects with attitude toward withdrawal of life sustaining treatment(β=.17, p=.001; β=.21, p<.001) and advance directive efficacy(β=.11, p=.040; β=.19, p=.002), respectively. Attitude toward withdrawal of life sustaining treatment and advance directive efficacy showed statistically significant direct effects on advance directive intent(β=.15, p=.007; β=.48, p<.001). Elderly parents' care burden and health status had a significant indirect effect on advance directive intent through attitude toward withdrawal of life sustaining treatment(β=.01, p=.041; β=.05, p=.036) and advance directive efficacy(β=.06, p=.049; β=.16, p=.006), respectively. The variables accounted for 26.1% of advance directive intent of the Korean group in their middle-age. Conclusion: It is necessary to develop an advance directive education program based on variables affecting advance directive intent for individuals in their middle-age.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.2
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• pp.87-99
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• 2023

Purpose : This study intended to provide essential data for developing measures for the stable settlement and expansion of the life-sustaining treatment decision system by identifying the effects on preparing advanced directives. Methods : The effects on preparing advance directives of older people were identified based on Andersen's behavioral model, using the 2020 Korean national survey on elderly. Data were statistically analyzed with SPSS Statistics ver 25.0 and the significance level (α) was set to .05. Results : For factors that influence the preparation of advance directives, the predisposing factor was .769 times less for women than men (p=.026). By age, it was 1.410 times higher (p=.006) for people in their 70s compared to people in their 60s and 1.675 times higher (p=.003) for those in their 80s. By the level of education, it was 1.617 times higher (p=.026) for those who have elementary school education compared to those who have no education, 1.596 times higher (p=.048) for those who have a middle school education, 2.313 times higher (p<.001) for those who have a high school education, and 3.827 times higher (p<.001) for those who have a college education. By religion, it was 1.328 times higher (p=.008) for those who have faith compared to those who do not. For possible factors, it was 2.325 times higher (p=.003) for those who spend 100,000 won or more on healthcare (monthly average) compared to those who do not spend. For necessary factors, it was 1.439 times higher (p=.041) for those with the chronic disease compared to those without. Conclusion : It is deemed a measure that can increase the preparation of advance directives, considering the characteristics of each cause, for the stable settlement of the life-sustaining treatment decision system.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.9
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• pp.432-439
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• 2019

This study was a qualitative study that attempted to find out the meaning of preparation for dying well that the elderly think through a question of how to prepare for dying well. The focus group interview was conducted on 10 elderly people aged 65 or older who visited the elderly welfare center in B city, Gyeonggi-do, and a total of two groups were interviewed with five subjects as one group. As a result, eight themes were drawn from four dimensions of physical, psychological, social, and spiritual aspects. In physical preparation, 'health management' and 'doing what you want to do' were derived. In psychological preparation, 'not regretting' and 'giving to others' were derived, and in social preparation, 'organizing property', 'determining a place of death you wish', and 'writing a letter of advance life sustaining care directives' were derived. In spiritual preparation, 'relying on religion' was derived. The elderly were preparing for well-being in various aspects, and when developing a program for well-being, the program should be planned to prepare for actual death in various aspects.

• Journal of Hospice and Palliative Care
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• v.15 no.1
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• pp.30-35
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• 2012

Purposes: Most medical schools in Korea do not provide adequate education in end-of-life care. This study was designed to illustrate the need to improve end-of-life care education and to assess the effect of the education on fourth-year medical students' awareness and attitude towards hospice and palliative care for terminally ill patients. Methods: One hundred sixty six fourth-year medical students were surveyed with questionnaires on end-of-life care before and after they received the education. Results: Before receiving the education, students most frequently answered "at the end of life" (33.6%) was appropriate time to write an advance medical directive. After the education, the most frequent answer was "in healthy status" (58.7%). More students agreed to withholding or withdrawing futile life-sustaining treatment increased after the education (48.1% vs. 92.5% (P<0.001) for cardiopulmonary resuscitation, 38.3% vs. 92.5% (P<0.001) for intubation and mechanical ventilation, 39.1% vs. 85.8% (P<0.001) for inotropics, 60.9% vs. 94.8% (P<0.001) for dialysis and 27.8% vs. 56.0% (P<0.001) for total parenteral nutrition). Significantly more students opposed euthanasia after the education (46.6% vs. 82.1%, P<0.001). All students agreed to the need for education in end-of-life care. Conclusion: After reflecting on the meaning of death through the end-of-life care education, most students recognized the need for the education. The education brought remarkable changes in students' awareness and attitude towards patients at the end of life. We suggest end-of-life care education should be included in the regular curriculum of all medical schools in Korea.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.111-121
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• 2017

Purpose: This study was performed to explore the current state of end-of-life (EoL) care education provided to new interns at two university hospitals. Methods: A questionnaire was given to incoming interns (N=64). The levels of acquired knowledge and experience of clinical observation were measured. Seven areas for self-assessment questions were identified and used to analyze the interns' attitudes towards EoL-related education and practice. Results: On average, participants learned five elements (nine in total) from EoL-related classes and two (seven in total) from clinical observation. The most frequently educated element was how to deliver bad news (96.9%) in the classroom setting and how to control physical symptoms (56.5%) in clinical observation. Less than 20% received training on EoL care communication, including discussion of advanced directives. Compared with participants who had no EoL training, those who had EoL training showed positive attitudes in all seven categories regarding overall satisfaction, interest and preparedness in relation to EoL-care classes and practice. Conclusion: Although interns are responsible for caring of dying patients, their EoL training in classroom and clinical settings was very insufficient. Further research should be conducted to establish an education system that provides sufficient knowledge and training on EoL care.