J Korean Med Sci.  2015 Feb;30(2):151-154. 10.3346/jkms.2015.30.2.151.

Experience of Advance Directives in a Hospice Center

• Kong BH
• An HJ
• Kim HS
• Ha SY
• Kim IK
• Lee JE
• Park YJ
• Kang YJ
• Kim YR
• Kim HK

• KMID: 2129644
• DOI: http://doi.org/10.3346/jkms.2015.30.2.151

Abstract

To protect patient autonomy when confronting death, the importance of advance directives (ADs) has recently became an issue and gradually accepted in Korea. However, in real practice, ADs were not completed by patients but their families in most cases. To analyze the current situation of performing ADs, we reviewed medical charts of 214 terminal cancer patients admitted to the hospice center from October 2012 to September 2013. Seventy-six (35.5%) patients completed ADs. All ADs were completed by patients themselves. The most common reason for not completing ADs was poor physical and/or mental condition. As a proxy, the majority of patients preferred their spouses (55.3%). Few patients wanted life sustaining treatment (1.3%), however palliative sedation was accepted in 89.5%. The median timing of ADs after admission was three (0-90) days, and duration of survival since ADs was 22 (1-340) days. In conclusion, approximately one third of terminal cancer patients completed ADs by themselves. Considering that patient's poor condition is the main reason for not completing ADs, earlier discussion regarding ADs is necessary to enhance patients' participation.

Keyword

Advance Directives; Hospice Care; Neoplasms

MeSH Terms

Adolescent
Adult
Advance Directives/psychology/*statistics & numerical data
Aged
Aged, 80 and over
Female
Hospices/*statistics & numerical data
Humans
Male
Middle Aged
Neoplasms/*mortality/psychology
*Palliative Care
Republic of Korea
*Terminal Care
Young Adult

Figure

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  Fig. 1 Preference for items of care in advance directives.

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