• Journal of Digital Convergence
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• v.16 no.9
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• pp.453-463
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• 2018

This research was a descriptive study to investigate the effects of nursing students' biomedical ethics, and critical thinking on attitudes toward withdrawal of life-sustaining treatment. The Participant were 367 nursing students and date were collected from November until December of 2017. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple regression with SPSS/WIN 21.0. There was a significant positive correlation between attitudes toward withdrawal of life-sustaining treatment. Also, the influencing factor on attitudes toward withdrawal of life-sustaining treatment were biomedical ethics, academic grade, subjective health status, and personality types. These factors explained 36.6% of variance. In conclusion, the higher the awareness of biomedical ethics, the more positive attitude toward the withdrawal of lifelong treatment. Based on the results above, we need to develop diverse and systematic educational programs for nursing students.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.1
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• pp.397-407
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• 2015

The purpose of this study was to evaluate the effect on knowledge, attitude and volition of DNR after implementing the educational program of withdrawing life sustaining treatment to elderly people. The subjects for this study were healthy elders over 65 year-old at J elderly center located at S city, Korea. Data were gathered from October 2 to November 9, 2012. Participants were randomly assigned to either experimental or control group. For the experimental group, a 50 minute educational program on withdrawing life-sustaining treatment program was delivered twice a week for 3 weeks, and the control group did not receive any education. DNR knowledge (F=4.158;p=.049), DNR attitude (F=39.60; p=.001) were higher in experimental group compare to control group. Changes in number of participants who were determined to choose DNR for themselves (p=.006), for spouse (p=.039) and for parents (p=.006) were significantly higher in experimental group compared to control group. The program was effective in changing participant's knowledge, attitude and volition toward DNR and this program can be utilized to guide the decision making process of DNR for elderly.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.93-99
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• 2017

Purpose: This study investigated changes in life-sustaining treatments in terminally ill cancer patients after consenting to a do-not-resuscitate (DNR) order. Methods: Electronic medical records were reviewed to select terminally ill cancer patients who were treated at the oncology unit of the Asan Medical Center, a tertiary hospital in South Korea and died between January 1, 2013 and December 31, 2013. Results: The median (range) age of the 200 patients was 59 (22~89) years, and 62% (124 persons) were male. Among all patients, 83.5% were aware of their medical condition, and 47.0% of the patients had their DNR order signed by their spouses. The median of the patients' hospital stay was 15 days, and time from admission to DNR decision was 10 days. After signing a DNR order, 35.7~100% of the life-sustaining treatments that had been provided at the time of the DNR decision making were administered. The most commonly discontinued interventions were transfusion (13.5%), blood test (11.5%) and parenteral nutrition (8.5%). Conclusion: It is necessary to define the scope of life-sustaining treatments for DNR patients. Treatment guidelines should be established as well to secure terminal patients' death with dignity after their consent to a DNR order, thereby avoiding meaningless life-sustaining treatments and allowing administration of active terminal care interventions.

• Journal of Hospice and Palliative Care
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• v.15 no.3
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• pp.147-154
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• 2012

Purpose: The purpose of this study is to understand family members' experience of deciding to withdraw life-sustaining treatments for terminally-ill patients in an unconscious state. Methods: Data were collected by performing an in-depth interview with eight terminally-ill patients' family members who decided to withdraw life-sustaining treatments. Colaizzi's phenomenological method was used for data analysis. Results: Questions were classified into 12 groups and finally into five categories. The five categories were about family members' frustration with patient's condition, emotional preparation for the patient's death upon medical professionals' recommendation, patient's wishes, exhaustion due to caring and past experiences related to life-sustaining treatment. Conclusion: Using the five categories, hospice and palliative professionals could better understand family members' decision making experience of withdrawing life-sustaining treatments for terminally-ill patients. Based on that, the family members could be provided with appropriate counseling and care, which in turn could improve hospice and palliative care intervention.

• The Korean Society of Law and Medicine
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• v.5 no.2
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• pp.320-352
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• 2004

• The Korean Society of Law and Medicine
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• v.6 no.1
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• pp.45-62
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• 2005

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.3
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• pp.429-437
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• 2019

This study was a descriptive study to investigate the factors influencing on attitude toward withdrawal of life-sustaining treatment of nursing students' consciousness of biomedical ethics, good death recognition and meaning of life. The subjects of this study were 293 nursing students attending college at P city. Data were collected for two weeks from May 1, 2018 to May 11, 2018. The statistical method was performed with SPSS WIN 22.0 using a complex sampling analysis, pearson's correlation coefficients, and a multiple regression analysis. The result of this study was significant positive correlation between attitude toward withdrawal of life-sustaining treatment and consciousness of biomedical ethics(r=.266, p<.001), good death recognition(r=.373, p<.001), meaning of life(r=.122, p=.037). The meaning of life was significant positive correlation consciousness of biomedical ethics(r=.294, p<.001), good death recognition(r=.230, p<.001). The good death recognition was significant positive correlation consciousness of biomedical ethics(r=.306, p<.001). Factors Influencing on the attitude toward withdrawal of life-sustaining treatment was good death recognition(${\beta}=.32$, p<.001) and consciousness of biomedical ethics(${\beta}=.16$, p=.004). These factors explained about 16% of the variance. Therefore it is necessary to develop an educational program to positively raise the attitude of consciousness of biomedical ethics and good death recognition.

• Journal of Hospice and Palliative Care
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• v.21 no.3
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• pp.92-103
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• 2018

Purpose: This descriptive study was conducted to examine factors that affect hospital workers in their decision to withdraw from life-sustaining treatment, such as knowledge, attitude, and perception of organ donation, transplantation, death and hospice palliative care. Methods: A questionnaire was completed by 228 workers of a tertiary general hospital, and data were analyzed using t-test, ANOVA, and Pearson's correlation by using SPSS 21.0. Results: The subjects' knowledge of biomedical ethics awareness differed by age, education level, occupation, affiliated department, and biomedical ethics education. Their knowledge of brain death, organ donation and transplantation was positively correlated with attitudes toward tissue donation and transplantation, knowledge of hospice palliative care, and perception of hospice palliative care. Their attitudes toward tissue donation and transplantation were significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care, and withdrawal of life-sustaining treatment. Their awareness of death was significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care and withdrawal of life-sustaining treatment. The perception of hospice palliative care was significantly correlated with withdrawal of life-sustaining treatment. Factors associated with their withdrawal of life-sustaining treatment were work at the hospice ward (32.5%), attitudes toward tissue donation and transplantation and perception of hospice palliative care. Conclusion: This study has shown that work at the hospice ward, attitudes toward tissue donation and transplantation and perception of hospice palliative care were related to attitudes toward withdrawal of life-sustaining treatment. More research is needed to further develop various curriculums based on biomedical methods.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.2
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• pp.539-547
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• 2021

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.

• Hospice
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• s.47
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• pp.2-5
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• 2010