강성규, 윤방부, 이예리, 이동배, 심운택 (1984). 가족기능지수(Family APGAR score)에 관한 기초조사연구, 대한가정의학회, 5(12), 6-13.
건강보험심사평가원 (2015). 2015년 진료비 평가지표.
국립암센터 (2008). 품위 있는 죽음에 대한 대국민 인식 조사. Retrieved November.
http://www.ncc.re.kr/prBoardView1.ncc?nwsId=533
국립연명의료관리기관 (2018). www.lst.go.kr
권영미 (2002). 간호학생의 도덕판단과 윤리적 가치관. 한국간호교육학회 지, 8(1), 17-28.
김기현 (2010). 폐암환자, 가족, 의사 간호사의 사전의료지시서에 대한 반응비교. 경희대학교 석사학위논문, 서울.
김미혜 (2016). 노인환자의 사전의료의향서 태도 결정에 영향을 미치는 요인 : 가족기능과 자기효능감을 중심으로. 공주 대학교 석사학위논문.
공주.
김명숙, 강문희, 김연옥 (2018). 지역사회 재가노인의 사전연명의료의향서 작성의료 영향요인. 한국콘텐츠학회논문지, 18(2), 240-247.
김명희, 강은희, 김미영 (2012). 의식 없는 말기환자 가족의 연명치료 중 단결정 경험, 한국호스피스·완화의료학회지, 15(3), 147-154.
김수진 (2016). 노인요양시설 거주노인의 웰다잉을 위한 간호실무 가이 드라인 개발, 고려대학교 대학원 박사학위논문, 서울.
김수현 (2010). 사전의료지시(서)에 대한 성인의 인식과 태도, 기본간호 학회지, 17(4), 450-459.
김애리 (2016). 국내병원의 사전의료의향서 및 심폐소생술금지 요청서 현황. 경희대학교 공공대학원 석사학위논문, 서울.
김옥수, 백성희 (2003). 노인의 외로움과 사회적지지, 가족 기능간의 관계
21-44.
서울대학교 석사학위논문. 서울.
신은영, 유시슨 (2005). 노인의 건강 신념에 따른 죽음 불안. 노인복지연
의향서 작성 의향. 한양대학교 석사학위논문, 서울.
연구. 동국대학교 불교문화대학원 석사, 서울
최경석 (2009). 사전지시(Advance Directives)제도의 윤리적 사회적 합 의. 홍익법학, 10(1), 93-112.
최성실 (2016). 일 노인요양시설 거주노인 주보호자의 사전의료의향서에 대한 지식과 태도. 서울대학교 석사학위논문, 서울.
최자윤 (2003). 시각적 상사 척도의 신뢰도 검사 -급성 통증 측정-. 한국
간호교육학회지, 9(1), 136-143.
1026-1034.
Alano G. J., Pekmezaris R., Tai J. Y., Hussain M. J., Jeune J., Lous B., El-Kass G., Ashraf M. S., Reddy R., Lesser M.,&
Wolf-Klein G. P.(2010). Factors influencing oler adult to complete advance directives. Palliavite and supportive Care, 8(3), 267-275.
Calvin, A, O. & Clark, A. P. (2002). How are you facilitating advance directives in your clinical nurse specialist practice? Clinical Nurse Specialist , 16(6), 293-294.
Detering, K. M., Hancock, A. D., Reade, M. C. Silvester, W.(2010).
The Impact of Advance Care Planning on End of Life Care in Elderly Patients. Randomised Controlled Trial. British Medical Journal, 340, c1345.
Hamel, Carole F., Guse, Lorna W., Hawranik, Pamela G., & Bond, J.B.
(2002). Advanc Directives and Community-Dwelling Older Adults. Western Journal of Nursing Research, 24(2), 143-158.
Kim, M. J., Foreman, M. D. (2011). Korean American adult children’s beliefs about what their paents want at the end of life.
Clinical Gerontlolgist, 34, 305-318.
Kim, S. H. (2011). Factors influencing preferences of Korean people toward advance directives. Nursing Ethics ,18(4), 503-513
Lawrence, J. F. (2009) The advance directive prevalence in long-term care: A comparison of relationships between a nurse practitioner healthcare model and a traditional healthcare model. Journal of the American Academy of Nurse Practitioners, 21, 179-185.
Lawston, M. P., Moss M, Fulcomer M, Kleban M. H. (1982). "A research and service oriented multi level assessment instruement", Journal of Gerontology, 37(1), pp. 91-99.
Luptak, M. K., & Boult, C. (1994). A method for increasing elders' use of advance directives. The Gerontologist, 34(3), 409-412.
McLaughlin, L. A., & Braun, K. L. (1998). Asian and Pacific Islander cultural values: Considerations for health care decision making.
Health & Social Work, 23 (2), 116-126.
Matsui, M. (2007). Perspectives of elderly people on advance directives in Japan, Journal of Nursing Scholarship, 39(2),
172-176.
Matsumura, S., Bito, S., Liu, H., Kahn, Fukuhara, S., Kagawa-Singer, M. & Wenger, N. (2002). Acculturation of attitudes toward end-of-life care: a cross-cultural survey of Japanese Americans and Japanese. Journal of General Internal Medicine, 17(7), 531-539.
Matzo, M., Hijjazi, K., & Outwater, M. (2008). Older Oklahoman's knowledge, attitudes, and behaviors related to advance directives. Journal of Gerontological Nursing, 34(2), 21-26.
Miller, J, R. & Ellen, H. J. (1980). Family focused care. New youk:
McGraw-Hill Book Company.
Murphy, Sheila T., Palmer, Joycelynne M., Ken, Stanley., Frank, Gelya., Miche, Vicki., & Blackhall, Leslie J. (1996). Ethinicity and advance care directives. The Journal of Law, Medicine &
Ethics, 24(2), 108-117.
Nolan, Marie T., & Bruder, Mark.(1997). Patients' atiitudes toward advance directive and end-of-life treament decision. Nursing outlook, 45(5), 204-208.
Perkins, H. S. (2000). Time to move advance care planning beyond advance directives. Chest, 117, 1228-1231.
Salmond, Susan W., & David, Estrella. (2005). Attitudes Toward Advance Directives and Advance Directive Completion Rates.
Orthopaedic Nursiong, 24(2), 117-127.
Seo, Young-Sook, Son, Yu-Lim, Sung, Ki-Wol. (2011). Factors related to the Death Attitudes among the Elderly Women in Rural Areas. J Korean Gerontol Nurs, 13(1), 21-28.
Singer, P. A. (1998). Quality end-of life care. Canadian Medical
Association Journal, 159, 159-162.
Siverira, M, j., KIM, S. Y. H., & Langa, K. M. (2010). Advance directives and outcomes of surrogate decision making before death. The New England Journal of Medicine , 362(13).
1211-1218.
Smilkstein, G. (1978). The family APGAR: a proposal for a family function test and its use by physicians, Journal of Family Practice, 6(6), 1231-1239.
Olson, D.H., & Killorin, E. (1992). Clinical Rating Scale for circumplex Model. St, Paul, M. N. :Family Social Science, University of Minnesota.
<부록 1>
<부록 2>
ABSTRACT
-This is a descriptive research study aiming to investigate the relationship between attitudes toward advance directive and family function in the elderly in the community and enhance implementation in drawing up advance directives.
The participants of this study were 145 elderly individuals aged 65 or older living in Gyeonggi Province, South Korea, who understood the purpose of and agreed to participate in this study. Data collection was conducted from December 25, 2017 to January 20, 2018, using a structured questionnaire.
The participants' attitudes toward advance directives were measured using the Korean version of the Advance Directive Attitude Survey(ADAS), which was originally developed and modified in 2003 by Nolan and Bruder(1997) and translated into Korean by Lee(2012). Family function was measured using the Family APGAR, which was originally developed by Smilkstein(1978) and modified by Kim and Baek(2003).
The collected data were analyzed using frequency, percentage, mean and standard deviation, χ2-test, t-test, one-way ANOVA, Scheffe's test, and Pearson's correlation coefficient using SPSS 18.0.
1. The mean score for attitude toward advance directives was 45.75(±5.50)(out of 64 point). By subdomain, the score for “the effects of advance directive on family members” was the highest (22.61±5.22 point), followed by the scores for “opportunities to choose treatment options"
(11.13±2.48), “the effects of advance directives on treatment" (9.10±1.59), and
“illness perception" with(2.92±0.62).
2. The mean score for the level of family function was 6.41(±2.79) out of 10 point. By function, the “healthy family function group" accounted for 44.3% and scored 9.19 point, the “moderate family function group" accounted for 42.9% and scored 4.87 points, and the “severe family dysfunction group"
accounted for 12.9% and scored 2 point
3. Concerning the difference in attitude toward advance directives according to the participants' general characteristics, higher perceived health status was found to be associated with more positive attitudes toward advance directives(F=4.58, p=.012).
4. There was a significant difference in attitudes toward advance directives between the groups according to the participants' family function.
The score for attitudes toward advance directives was significantly lower in the severe family dysfunction group(F=5.85, p=.004).
5. There was a significant positive correlation between the participants' attitudes toward advance directives and family function(r=.29, p=.001).
Taken together, the results of this study demonstrated that there was a correlation between attitudes toward advance directives and family function among community elderly, and can provide baseline data for building positive attitudes toward advance directives.
Keywords: Advance directives, Attitudes toward advance directives, Elderly people, Family function.