Journal List > J Korean Acad Nurs > v.42(4) > 1002829

TOOLS
Kim, Hong, Eun, and Koh: Prerequisite for Korean Advance Directives: From the View of Healthcare Providers
Original Article
Journal of Korean Academy of Nursing

Journal of Korean Academy of Nursing 2012; 42(4): 486-495.

Published online: 31 August 2012

DOI: https://doi.org/10.4040/jkan.2012.42.4.486

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

Shin Mi Kim1, Sun Woo Hong2, Young Eun3, Su Jin Koh4

1Department of Nursing, Changwon National University, Changwon, Korea.

2Department of Emergency Medical Technology, Daejeon University, Daejeon, Korea.

3College of Nursing, Institute of Health Sciences, Gyeongsang National University, Jinjoo, Korea.

4Oncology, Good Samaritan Hospital, Pohang, Korea.

Address reprint requests to: Hong, Sun Woo. Department of Emergency Medical Technology, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 300-716, Korea. Tel: +82-42-280-2938, Fax: +82-42-280-2946, swhong@dju.kr

Received 14 November 2011       Accepted 18 July 2012

© 2012 Korean Society of Nursing Science

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.

Keywords: Advance directives, Focus groups, Healthcare providers

Figures and Tables

Table 1
Question List for Korean Advance Directives
jkan-42-486-i001

AD=Advance directives; DNR=Do not resuscitate;

POLST=Physician's order of life-sustaining treatment.

Table 2
Characteristics of the Participants (N=11)
jkan-42-486-i002
Table 3
Major Themes, Subcategory and Attributes of Korean AD
jkan-42-486-i003

AD=Advance directives.

Notes

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (2010-0021379).

References

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.
TOOLS
Similar articles