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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.



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


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.


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.


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.


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)


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

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