Korean J Hosp Palliat Care.  2016 Jun;19(2):109-118. 10.14475/kjhpc.2016.19.2.109.

The Evaluation of the Korean Advance Directives (K-AD)

  • 1Department of Nursing, Changwon National University, Changwon, Korea. ddoriru@gmail.com
  • 2Department of Emergency Medicine Technology, Daejeon University, Daejeon, Korea.
  • 3College of Nursing, Gachon University, Seongnam, Korea.


The purpose of this study was to evaluate Korean advance directives (K-AD) by examining the degree of adults' acceptance and reliability of the directive itself.
Survey was performed with 181 adults aged 20 or older who were recruited from three regions. A questionnaire used to examine the participants' acceptance of their K-AD in terms of visual analogue scale score of complexity, difficulty, necessity, satisfaction, recommendation. Then, a retest was carried out by asking participants to write up a K-AD again to confirm the reliability of the directives.
On a scale of 100, the average acceptance score was 70 or above, which represents rather high level of acceptance in all five categories. The test-retest reliability kappa values ranged from 0.592 to 0.950, and the conformity degree was moderate or high. Regarding K-AD components such as values, treatment preference, proxy appointment, differences among age groups were observed in each component.
The results of this study suggest that K-AD is a feasible instrument to analyze its acceptability and reliability for adult population. K-AD could be utilized to help people make their own decision on their end-of-life care. Further studies are needed to confirm this study results and promote widespread use of K-AD.


Advance directives; Terminal care; Feasibility studies
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