J Korean Gerontol Nurs.  2026 Feb;28(1):26-37. 10.17079/jkgn.2025.00178.

Effects of awareness of person-centered care, knowledge of life-sustaining treatment decisions, and attitudes toward advance directives on end-of-life care competency among nurses in long-term care hospitals: A cross-sectional study

• Jang SO
• Ryu S

• KMID: 2579313
• DOI: http://doi.org/10.17079/jkgn.2025.00178

Abstract

Purpose
This study aimed to investigate the factors influencing end-of-life care competency by examining awareness of person-centered care, knowledge of life-sustaining treatment decisions, and attitudes toward advance directives among nurses in long-term care hospitals. Methods: Through convenience sampling, nurses with more than 6 months of clinical experience and who were responsible for inpatient care in long-term care hospitals in Jennam-do and Gwangju-metropolitan city were selected to participate in this study. Data were collected using a structured self-administered questionnaire between December 1 and 23, 2023. Data were analyzed through descriptive statistics, independent t-test, one-way ANOVA, Scheffé’s test, Pearson’s correlation coefficient, and multiple regression analysis. Results: End-of-life care competency had an average of 3.72 out of 5 points. “Collaboration with team members” had the highest average score and “professional development” the lowest. Multiple regression analysis identified that awareness of person-centered care (β=.31, p<.001), attitudes toward advance directives (β=.31, p<.001), and providing end-of-life care 11 times or more in the past year (β=.17, p=.014) significantly influenced end-of-life care competency. Conclusion: Various educational strategies that promote awareness of person-centered care and foster positive attitudes toward advance directives are needed to enhance nurses’ end-of-life care competency in long-term care hospitals. Additionally, educational programs that provide opportunities for both direct and indirect experience in end-of-life care are needed, as such programs can help establish a system to ensure the delivery of high-quality end-of-life care.

Keyword

Long-term care; Terminal Care; Patient-Centered Care; Advance directives; Life Support Care