| Home | E-Submission | Sitemap | Contact Us |  
top_img
J Korean Gerontol Nurs Search

CLOSE

J Korean Gerontol Nurs > Volume 16(2):2014 > Article

Original Article

J Korean Gerontol Nurs. 2014 Aug;16(2):160-169. Korean.
Published online Aug 31, 2014.  http://dx.doi.org/10.17079/jkgn.2014.16.2.160
© 2014 Korean Gerontological Nursing Society
Attitudes toward Advance Directives of Older Adults using Senior Centers
Hae-Lim Lee,1and Yeon-Hwan Park*2
1Asan Medical Center, Seoul, Korea.
2College of Nursing & The Research Institute of Nursing Science, Seoul National University, Seoul, Korea.

*Corresponding author: Park, Yeon-Hwan. College of Nursing, Seoul National University, 28 Yeongeon-dong, Jongro-gu, Seoul 110-799, Korea. Tel: +82-2-740-8846, Fax: +82-2-765-4103, Email: hanipyh@snu.ac.kr
Received February 24, 2014; Revised April 14, 2014; Accepted July 11, 2014.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Purpose

The aims of this study were to identify attitudes toward advance directives (ADs) of community dwelling older adults and factors related to ADs.

Methods

Participants were 180 older Korean adults (mean age=74.2 years, 70.6% women) from two senior centers in a metropolitan city in South Korea. Data were collected through face to face interviews during September, 2011. The Advanced Directives Attitude Survey (ADAS) and questionnaires including socio-demographic and health related characteristics were used. Data were analyzed using t-test, one-way ANOVA, and Scheffé test.

Results

The mean score for ADAS was 45.12, which showed elders' positive attitudes toward ADs. Of the elders, 61.1% agreed to prepare ADs. The socio-demographic characteristics of age, level of education, and monthly income were significantly related to the elders' attitudes toward ADs. In addition, medical service use, medical expenses, experiences of significant others' admission in intensive care units and death were significantly related factors to the elders' attitudes toward ADs.

Conclusion

Findings from this study suggest that thoughtful approaches with respect for values and attitudes of older adults need to be considered in adapting ADs to Korean health care systems.

Keywords: Advance directives, Attitudes, Aged.

Tables


Table 1
Attitude toward Advanced Directives (AD) of Participants (N=180)


Table 2
The Subscale of Attitude toward Advanced Directives of Participants (N=180)


Table 3
Differences in Attitude toward Advanced Directives by Socio-demographic Characteristics of Participants (N=180)


Table 4
Differences in Attitude toward Advanced Directives by Health related Characteristics of Participants (N=180)


Table 5
Attitude toward Advanced Directives related to Intention to Make Advanced Directives (N=180)

Notes

This article is a condensed form of the first author's master's thesis from Seoul National University.

References
1. Cho MJ, Bae JN, Suh GH, Hahm BJ, Kim JK, Lee DW, et al. Validation of Geriatric Depression Scale, Korean version (GDS) in the assessment of DSM-III-R major depression. J Korean Neuropsychiatr Assoc 1999;38(1):48–62.
2. Del Pozo PK, Hidalgo JL, Herráez MJ, Bravo BN, Rodríguez JO, Guillén VG. Study of the factors influencing the preparation of advance directives. Arch Gerontol Geriatr 2014;58(1):20–24.
3. DeLuca Havens GA. Differences in the execution/nonexecution of advance directives by community dwelling adults. Res Nurs Health 2000;23(4):319–333.
4. Fishbein M, Ajzen I. Belief, attitude, intention, and behavior: An introduction to theory and research. MA: Addison-Wesley; 1975.
5. Gwon BK. Aging society and well-dying: More than half of all lifetime medical spending one month before the end-of-life. Sci Tech 2009 May 23;481:36–39.
6. Gwon YC, Park JH. Korean Version of Mini-Mental State Examination (MMSE-K). J Korean Neuropsychiatr Assoc 1989;28(1):125–135.
7. Hong SA. An empirical study for model development concerning advance directives. J Korean Gerontol Soc 2010;30(4):1197–1211.
8. Kierner KA, Hladschik-Kermer B, Gartner V, Watzke HH. Attitudes of patients with malignancies towards completion of advance directives. Support Care Cancer 2010;18(3):367–372.
9. Kim MY. Survey on Korean nurses' attitude towards advance directives and end of life decision making. Seoul: Seoul National University; 2010.
Unpublished master's thesis
10. Kim SH. Factors influencing preferences of Korean people toward advance directives. Nurs Ethics 2011;18(4):505–513.
11. Kim SM, Hong YS, Kim HS. A history of advance directives. Korean J Med Ethics 2010;13(3):193–204.
12. Kim SM, Kim SY, Lee MA. Review on advance directives. J Korean Acad Nurs 2001;31(2):279–291.
13. Korean Academy of Medical Sciences. Medical ethics guideline for discontinuance treatment of terminally ill patients, Part 1. Seoul: Author; 2002.
14. Lawrence JF. The advance directive prevalence in longterm care: A comparison of relationships between a nurse practitioner healthcare model and a traditional healthcare model. J Am Acad Nurse Pract 2009;21(3):179–185.
15. Lee JA. Medical personnel (doctors and nurses)'s perception about withdrawing life sustaining treatment and advance directives for terminally ill cancer patients: Focus group interviews. Seoul: Korea University; 2009.
Unpublished master's thesis
16. Lee SM. Patient and family determination in medical decision-making. Korean J Med Ethics 2009;12(4):323–334.
17. Malloy T, Wigton R, Meeske J, Tape T. The influence of treatment descriptions on advance medical directive decisions. J Am Geriatr Soc 1992;40(12):1255–1260.
18. Mezey MD, Leitman R, Mitty EL, Botrell MM, Ramsey GC. Why hospital patients do and do not execute advance directives. Nurs Outlook 2000;48(4):165–171.
19. Min JH. Lawmaker Kim SYProposes the Death with Dignity Bill. Dailymedi; 2014 Mar 11;March 15, 2014
from http://dailymedi.com/news/view.html?section=1&category=3&no=777787
20. Nam YH, Seo IS, Im JH, Choi JH, Kim JE, Choi JH, et al. Application of advance directives for patients with end stage renal disease. Korean J Nephrol 2008;27(1):85–93.
21. Nicholas LH, Langa KM, Iwashyna TJ, Weir DR. Regional variation in the association between advance directives and end-of-life medicare expenditures. JAMA 2011;306(13):1447–1453.
22. Nolan MT, Bruder M. Patients' attitudes toward advance directives and end-of-life treatment decisions. Nurs Outlook 1997;45(5):204–208.
23. Park YT. Medical Payments from the latest trends in the elderly. Health Insur Rev Assess Serv Policy Brief 2013 Jul 01;7(4):53–61.
24. Rein AJ, Harshman DL, Frick T, Phillips JM, Lewis S, Nolan MT. Advance directive decision making among medical inpatients. J Prof Nurs 1996;12(1):39–46.
25. Sung BM, Cho J, Choa M, Chung HS, Chung SP, Park IC. Attitudes of elderly persons toward advanced directives after providing prognostic information on cardiopulmonary resuscitation(CPR). J Korean Geriatr Soc 2008;12(3):153–159.
26. Wilson DM, Houttekier D, Kunju SA, Birch S, Cohen J, MacLeod R, et al. A population-based study on advance directive completion and completion intention among citizens of the western Canadian province of Alberta. J Palliat Care 2013;29(1):5–12.
27. Yu HJ. Doctor's duty of informed consent and patient informed consent form. Korean J Med Ethics 2002;5(1):1–15.
28. Yun ES. Knowledge, experience, attitudes and preferences toward advance directives among patients and their family members who are visiting the general hospital. Seoul: Hanyang University; 2009.
Unpublished master's thesis
29. Yun YH, Lee YS, Nam SY, Chae YM, Heo DS, Lee SW, et al. Public attitudes toward dying with dignity and hospice palliative care. Korean J Hosp Palliat Care 2004;7(1):17–28.
Editorial Office
College of Nursing, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760 Republic of Korea
Tel : +82-2-3277-6693   Fax : +82-2-3277-6693   E-mail: jkgneditor@gmail.com
About |  Browse Articles |  Current Issue |  For Authors and Reviewers
Copyright © by The Korean Gerontological Nursing Society.     Developed in M2PI