J Korean Acad Nurs.  2012 Aug;42(4):486-495. 10.4040/jkan.2012.42.4.486.

Prerequisite for Korean Advance Directives: From the View of Healthcare Providers

Affiliations
  • 1Department of Nursing, Changwon National University, Changwon, Korea.
  • 2Department of Emergency Medical Technology, Daejeon University, Daejeon, Korea. swhong@dju.kr
  • 3College of Nursing, Institute of Health Sciences, Gyeongsang National University, Jinjoo, Korea.
  • 4Oncology, Good Samaritan Hospital, Pohang, Korea.

Abstract

PURPOSE
The purpose of this study was to explore the main prerequisite for Korean Advance Directives [KAD] to ensure their better use.
METHODS
Data were collected from two focus group interviews and individual email responses. Study participants were 5 doctors and 6 nurses. All interview data were transcribed and analyzed using qualitative content analysis.
RESULTS
Three main themes emerged; establishing a philosophy of KAD, protocol to practice KAD, and the KAD document itself. A philosophy is needed to ensure individual needs, consensus to practice AD and identify principle agents. The core of protocol was found to be as follows; 1) process, 2) premise, 3) procedure, 4) contextual preparation, 5) timing, 6) feasibility. Component and feasibility need to be established for the document itself.
CONCLUSION
For a positive acceptance of KAD in Korean society, a culture sensitive, reality based, and user friendly AD needs to be developed.

Keyword

Advance directives; Focus groups; Healthcare providers

MeSH Terms

Adult
*Advance Directives
Asian Continental Ancestry Group
Female
Focus Groups
Health Personnel/*psychology
Humans
Interviews as Topic
Male
Middle Aged
Qualitative Research
Questionnaires
Republic of Korea

Reference

1. Fagerlin A, Schneider CE. Enough. The failure of the living will. The Hastings Center Report. 2004. 34(2):30–42.
2. Hahn ME. Advance directives and patient physician communication. Journal of the American Medical Association. 2003. 289:96. http://dx.doi.org/10.1001/jama.289.1.96.
3. Haisfield ME, McGuire DB, Krumm S, Shore AD, Zabora J, Rubin HR. Patients' and healthcare providers' opinions regarding advance directives. Oncology Nursing Forum. 1994. 21:1179–1187.
4. Hsieh H, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005. 15:1277–1288. http://dx.doi.org/10.1177/1049732305276687.
5. Heo DS. Patient autonomy and advance directives in Korea. Journal of the Korean Medical Association. 2009. 52:865–870. http://dx.doi.org/10.5124/jkma.2009.52.9.865.
6. Kim KW. National movement to complete advance directives-Starts as civil movement. Yonhap News Agency. 2010. 12. 15. Retrieved November 11, 2011. from http://www.yonhapnews.co.kr/bulletin/2010/12/14/0200000000AKR20101214203900017.HTML?did=1179m.
7. Kim S, Lee Y, Kim S. Attributes considered important for a good death among elderly and adults. Journal of the Korea Gerontological Society. 2003. 23:95–110.
8. Kim SY. The right for natural death at the end-of-life bill. 2009. Retrieved October 15, 2011. from http://www.ksy.or.kr/bbs/viewbody.php?code=policyActive&page=4&id=32&number=32&keyfield=&keyword=&category=&BoardType=&admin=.
9. Kim SM. Advance directives and proxy decision-making. Korean Journal of Medical Ethics. 2010. 13:29–42.
10. Kirschner KL. When written advance directives are not enough. Clinics in Geriatric Medicine. 2005. 21:193–209. http://dx.doi.org/10.1016/j.cger.2004.08.006.
11. Kwon I, Koh Y, Ho YY, Heo DS, Seo SY, Kim H, et al. A study of the attitudes of patients, family members, and physicians toward withdrawal of medical treatment for terminal patients in Korea. Korean Journal of Medical Ethics. 2010. 13:1–16.
12. Levi BH, Green MJ. Too soon to give up: Re-examining the value of advance directives. The American Journal of Bioethics. 2010. 10(4):3–22. http://dx.doi.org/10.1080/15265161003599691.
13. Lo B, Steinbrook R. Resuscitating advance directives. Archives of Internal Medicine. 2004. 164(14):1501–1506. http://dx.doi.org/10.1001/archinte.164.14.1501.
14. Ministry of Health & Welfare. Press release: Consensus report on withdrawing life-sustaining-treatment of a consultative body for social consensus. 2010. 07. 14. Retrieved November 1, 2011. from http://www.mw.go.kr/front/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&BOARD_ID=140&BOARD_FLAG=00&CONT_SEQ=238554&page=1.
15. Oh D, Kim J, Lee C, Lim J, Jung K, Heo DS, et al. Discrepancies among patients, family members, and physicians in Korea in terms of values regarding the withholding of treatment from patients with terminal malignancies. Cancer. 2004. 100:1961–1966. http://dx.doi.org/10.1002/cncr.20184.
16. Park HW. The implications and significance of the case at Severance Hospital. Journal of the Korean Medical Association. 2009. 52:848–855. http://dx.doi.org/10.5124/jkma.2009.52.9.848.
17. Koch KA. Patient self-determination act. The Journal of Florida Medical Association. 1992. 79:240–243.
18. Prendergast TJ. Advance care planning: Pitfalls, progress, promise. Critical Care Medicine. 2001. 29:2 Suppl. N34–N39.
19. Ramsaroop SD, Reid MC, Adelman RD. Completing an advance directive in the primary care setting: What do we need for success? Journal of the American Geriatric Society. 2007. 55:277–283. http://dx.doi.org/10.1111/j.1532-5415.2007.01065.x.
20. Rao JK, Alongi J, Anderson LA, Jenkins L, Stokes G, Kane M. Development of public health priorities for end-of-life initiatives. American Journal of Preventive Medicine. 2005. 29:453–460. http://dx.doi.org/10.1016/j.amepre.2005.08.014.
21. Sabatino CP. Advance directives and advance care planning: Legal and policy issues. 2007. Washington, D.C: U.S. Department of Health and Human Services.
22. Sandelowski M. The problem of rigor in qualitative research. Advances in Nursing Science. 1986. 8(3):27–37.
23. Seymour J, Gott M, Bellamy G, Ahmedzai SH, Clark D. Planning for the end of life: The views of older people about advance care statements. Social Science and Medicine. 2004. 59:57–68.
24. Shin SJ, Joo SY, Yim DG, Kim ST, Ahn SS, Lee HS, et al. Dying with dignity law. 2009. Retrieved November 11, 2011. from http://www.ssj.or.kr/02_political/index.php?bbs_id=agreement2&num=935&page=6&key=&keyword=&btype=&mode=view.
25. Statistics Korea. Death for 19 chapters of causes by place of death. 2009. Retrieved October 11, 2011. from http://kostat.go.kr/wnsearch/search.jsp.
26. Steinhauser KE, Christakis NA, Clipp EC, McNeilly M, Mclntyre L, Tulsky JA. Factors considered important at the end of life by patients, family, physicians, and other care providers. Journal of the American Medical Association. 2000. 284:2476–2482. http://dx.doi.org/10.1001/jama.284.19.2476.
27. Supreme Court. A sentence 2002 Do 995 [Murder (ruling: aiding murder), murder] [Kong 2004.8.1.(207), 1255]. 2004. 06. 24. Retrieved November 11, 2011. from http://glaw.scourt.go.kr/jbsonw/jbson.do.
28. Supreme Court. A sentence 2009 Da 17417 court's ruling from the full panel of judges [Withdrawal of meaningless life-sustaining-treatment] [Kong 2009 Sang, 849]. 2009. 05. 21. Retrieved November 11, 2011. from http://glaw.scourt.go.kr/jbsonw/jbson.do.
29. Yun YH, Rhee YS, Nam SY, Chae YM, Heo DS, Lee SW, et al. Public attitudes toward dying with dignity and hospice · palliative care. Korean Journal of Hospice and Palliative Care. 2004. 7:17–28.
Full Text Links
  • JKAN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr