Korean J Adult Nurs.  2013 Apr;25(2):207-218.

Preferences for Care near the End of Life according to Chronic Patients' Characteristics

• Yun S
• Kang J

Abstract

PURPOSE
The purpose of this study was to explore the chronic patients' references for care near the end of life.
METHODS
This is a descriptive survey research, with subjects of 161 outpatients with hypertension, diabetes mellitus or chronic renal failure.
RESULTS
The majority of the subjects do not want meaningless life sustaining treatment and they report thinking positively about family or health care professional to participate in their end of life decision making process. Subjects reported preferring adequate pain management and spiritual support at the end of life. In regard to advance directives (ADs), those subjects with chronic disease report thinking positively about the necessity of ADs and its institutionalization. However, the subjects report not having the detailed information on the proper time and method of writing their ADs.
CONCLUSION
Based on these results, educational programs on end of life decision making for chronic patients need to be developed. Also, the nurse should try to reflect the opinion of chronic patients as much as possible when make an end-of-life decision.

MeSH Terms

Advance Directives
Chronic Disease
Decision Making
Delivery of Health Care
Diabetes Mellitus
Humans
Hypertension
Institutionalization
Outpatients
Pain Management
Terminal Care
Thinking
Writing

Reference

Byock I. R.1996. The nature of suffering and the nature of opportunity at the end of life. Clinics in Geriatric Medicine. 12(2):237–252.

Cox P.2005. Managing chronic diseases: palliative care spectrum starts early on. British Medical Journal. 330(7497):963. http://dx.doi.org/10.1136/bmj.330.7497.963.

Gauthier D. M.., Froman R. D.2001. Preference for care near the end of life: scale development and validation. Research in Nursing & Health. 24(4):298–306.

Gutierrez K. M.2012. Advance directives in an intensive care unit: Experiences and recommendations of critical care nurses and physicians. Critical Care Nursing. 35(4):396–409. http://dx.doi.org/10.1097/CNQ.0b013e318268fe35.

Hong S.., Moon S.2007. Study on preference for life-sustaining treatment classified by family members. Journal of the Korean Gerontological Society. 27(4):881–895.

Janssen D. J.., Spruit M. A.., Schols J. M.., Nawrot T. S.., Curtis J. R.2011. Predicting changes in preferences for life-sustaining treatment among patients with advanced chronic organ failure. Chest. 141(5):1251–1259. http://dx.doi.org/10.1378/chest.11-1472.

Jeong K.2006. An analysis of articles about quality of life of chronic illness. Journal of the Kimcheon Science College. 32:5–11.

Jo K. H.2012. Development and evaluation of shared medical decision-making scale for end-of-life patients in Korea. Journal of Korean Academy of Nursing. 42(4):453–465. http://dx.doi.org/10.4040/jkan.2012.42.4.453.

Jo K. H.., An K. J.., Kim G. M.., Kim Y. J.2012. Predictive factors for city dwellers' attitudes toward death with dignity. Korean Journal Hospice and Palliative Care. 15(4):193–204.

Keam B.., Yun Y. H.., Heo D. S.., Park B. W.., Cho C. H.., Kim S., et al. 2013. The attitudes of Korean cancer patients, family, caregivers, oncologists, and members of the general public toward advance directives. Support Care Cancer. 21(5):1437–1444. http://dx.doi.org/10.1007/s00520-012-1689-z.

Kim H. S.., Kim S.., Yu S. J.., Kim M.2010. The preference for care near the end of life of Korea nurses. The Korean Journal of Hospice and Palliative Care. 13(1):41–49.

Kim M. Y.., Kim K. S.2010. Korean nurses' attitude towards advance directives and end of life decision making. Journal of Korean Critical Care Nursing. 3(2):77–90.

Kim S. H.., Lee W. H.2011. An integrative review of do-not-resuscitate decisions in Korea. Korean Journal Medical Ethics. 14(2):171–184.

Kim S. Y.., Lee M. A.., Kim S. M.2001. Survey on preferences towards advance directives in Korean adults. Korean Journal Ethics. 4(2):231–244.

Kim S.., Hong Y.., Kim H.2010. A history of advance directives. Korean Journal of Medical Ethics. 13:193–204.

Kim S.., Lee Y.., Kim S.2003. Attributes considered important for a good death among elderly and adults. Journal of the Korean Gerontological Society. 23(3):95–110.

Korea Catholic Hospice Association. 2005. Understanding of hospice. Seoul: Hyunmoonsa.

Korean Academy of Medical Science. 2002. Guide for medical ethics among stop of life-sustaining. Seoul: Author.

Lee P. S.., Kim S. I.., Kim S. Y.., Lee S. J.., Park E. S.., Park Y. J., et al. 2002. Nursing need of patients with chronic illness - a primary study for development for the nursing center of chronic illness. Journal of Korean Academy of Nursing. 32(2):165–175.

Lee Y.., Kim S.2009. Validating the Korean version of the preferences for care near the end of life (PCEOL-K) scale. Korean Journal of Medical Ethics. 12:29–42.

Meeker M. A.., Jezewski M. A.2004. A voice for the dying. Clinical Nursing Research. 13:326–342. http://dx.doi.org/10.1177/1054773804267725.

Ministry of Health & Welfare. 2008. 2007 Dictionary of ministry of health and welfare. Seoul: Author.

Miyata H.., Shiraishi H.., Kai I.2006. Survey of the general public's attitudes toward advanced directives in japan: How to respect patient's preferences. BioMed Central Medical Ethics. 7:E11. http://dx.doi.org/10.1186/1472-6939-7-11.

Schirm V.., Sheehan D.., Zeller R. A.2008. Preference for care near the end of life: Instrument validation for clinical practice. Critical Care Nursing. 31(1):24–32. http://dx.doi.org/10.1097/01.CNQ.0000306393.79282.5b.

Statics Korea. 2013. The prevalence of chronic illness. Retrieved April 10, 2013, from. http://www.index.go.kr/egams/stts/jsp/potal/stts/PO_STTS_IdxMain.jsp?idx_cd=1438.

The Chosunilbo. 2010, January. Withdrawing life sustaining treatment. Retrieved November 15, 2012, from the Chosunilbo Web site:. http://news.chosun.com/site/data/html_dir/2010/01/10/2010011000411.html.

The Chosunilbo. 2012, November. Institutionalization of 'withdrawing life support'. Retrieved November 11, 2012, from the Chosunilbo Web site:. http://news.chosun.com/site/da-ta/html_dir/2012/11/03/2012110300208.html.

Thelen M.2005. End-of-life decision making in intensive care. Critical Care Nurse. 25(6):28–37.

White P.2005. Managing chronic diseases: End of life is more than death. British Medical Journal. 330(7497):963. http://dx.doi.org/10.1136/bmj.330.7497.963-a.

Yun E. S.2009. Knowledge, experience, attitudes and preferences toward advance directives among patients and their family members who are visiting the general hospital. Unpublished master's thesis, Hanyang University, Seoul.