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KIM, Young Ae

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Attitudes of the general public, cancer patients, family caregivers, and physicians toward advance care planning - a nationwide survey prior to the enforcement of the life-sustaining treatment decision-making act

PARK, Hye Yoon ; KIM, Young Ae ; SIM, Jin-Ah ; LEE, Jihye ; RYU, Hyewon ; LEE, Jung Lim ; MAENG, Chi Hoon ; KWON, Jung Hye ; KIM, Yu Jung ; NAM, Eun Mi ; SHIM, Hyun-Jeong ; SONG, Eun-Kee ; JUNG, Kyung Hae ; KANG, Eun Joo ; KANG, Jung Hun ; YUN, Young Ho
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 26/12/2018, Pagination inconnue

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Thème : Soins.

PLANIFICATION ; ANTICIPATION ; SOIN ; COREE ; PATIENT ; CANCER ; AIDANT ; MEDECIN

CONTEXT: To respect a patient's wish for end-of-life care, "the Act on Decisions on Life-Sustaining Treatment for Patients at the End-of-Life" was enacted in South Korea in 2016. Current understanding of people who would be involved in advance care planning (ACP) is crucial to disseminate it systematically.
OBJECTIVES: To investigate awareness and attitudes toward ACP in South Korea.
METHODS: A multicenter, nationwide cross-sectional study was conducted a survey regarding ACP among four groups that would have different positions and experiences: 1,001 cancer patients, 1,006 family caregivers, 928 physicians, and 1,241 members of the general public.
RESULTS: A total of 15% of the general population, 33% of the patients and caregivers, and 61% of the physicians had knowledge of advance directives. More than 64% of the general population, above 72% of the patients and caregivers, and 97% of the physicians were willing to do so when the disease status was aggravated or terminal. The possibility for changing the plan, uncertainty as to whether directives would actually be followed, and psychological discomfort were common reasons for not wanting to engage in ACP. Routine recommendations for a specific medical condition, heightened accessibility, and health insurance support were common factors that could help facilitate ACP.
CONCLUSION: Our findings suggest that strategies for promoting ACP should reflect different perspectives among the general public, patients, family caregivers, and physicians. Public advocacy, resources for approaching and integrating ACP into routine healthcare, as well as systematic support provisions, are needed.

Origine : PubMed

Comparison of attitudes towards five end-of-life care interventions (active pain control, withdrawal of futile life-sustaining treatment, passive euthanasia, active euthanasia and physician-assisted suicide) - a multicentred cross-sectional survey of Korean patients with cancer, their family caregivers, physicians and the general Korean population

YUN, Young Ho ; KIM, Kyoung-Nam ; SIM, Jin-Ah ; YOO, Shin Hye ; KIM, Miso ; KIM, Young Ae ; KANG, Beo Deul ; SHIM, Hyun-Jeong ; SONG, Eun-Kee ; KANG, Jung Hun ; KWON, Jung Hye ; LEE, Jung Lim ; NAM, Eun Mi ; MAENG, Chi Hoon ; KANG, Eun Joo ; DO, Young Rok ; CHOI, Yoon Seok ; JUNG, Kyung Hae
BMJ Open, 11/09/2018, vol.8, n°9, p. 1-12

Document en ligne

Thème : Soins. Cote : eD02.03

ATTITUDE ; FIN VIE ; CONTROLE DOULEUR ; ARRET THERAPEUTIQUE ; ACHARNEMENT THERAPEUTIQUE ; EUTHANASIE ; COREE ; SUICIDE MEDICALEMENT ASSISTE ; PATIENT ; CANCER ; AIDANT NATUREL ; MEDECIN ; MORT ; REPRESENTATION MORT

OBJECTIVES: This study determined attitudes of four groups-Korean patients with cancer, their family caregivers, physicians and the general Korean population-towards five critical end-of-life (EOL) interventions-active pain control, withdrawal of futile life-sustaining treatment (LST), passive euthanasia, active euthanasia and physician-assisted suicide.
DESIGN AND SETTING: We enrolled 1001 patients with cancer and 1006 caregivers from 12 large hospitals in Korea, 1241 members of the general population and 928 physicians from each of the 12 hospitals and the Korean Medical Association. We analysed the associations of demographic factors, attitudes towards death and the important components of a 'good death' with critical interventions at EoL care.
RESULTS: All participant groups strongly favoured active pain control and withdrawal of futile LST but differed in attitudes towards the other four EoL interventions. Physicians (98.9%) favoured passive euthanasia more than the other three groups. Lower proportions of the four groups favoured active euthanasia or PAS. Multiple logistic regression showed that education (adjusted OR (aOR) 1.77, 95% CI 1.33 to 2.36), caregiver role (aOR 1.67, 95% CI 1.34 to 2.08) and considering death as the ending of life (aOR 1.66, 95% CI 1.05 to 1.61) were associated with preference for active pain control. Attitudes towards death, including belief in being remembered (aOR 2.03, 95% CI 1.48 to 2.79) and feeling ‘life was meaningful’ (aOR 2.56, 95% CI 1.58 to 4.15) were both strong correlates of withdrawal of LST with the level of monthly income (aOR 2.56, 95% CI 1.58 to 4.15). Believing ‘freedom from pain’ negatively predicted preference for passive euthanasia (aOR 0.69, 95% CI 0.55 to 0.85). In addition, ‘not being a burden to the family’ was positively related to preferences for active euthanasia (aOR 1.62, 95% CI 1.39 to 1.90) and PAS (aOR 1.61, 95% CI 1.37 to 1.89).
CONCLUSION: Groups differed in their attitudes towards the five EoL interventions, and those attitudes were significantly associated with various attitudes towards death.

Origine : PubMed

Priorities of a "good death" according to cancer patients, their family caregivers, physicians, and the general population - a nationwide survey

YUN, Young Ho ; KIM, Kyoung-Nam ; SIM, Jin-Ah ; KANG, EunKyo ; LEE, Jihye ; CHOO, Jiyeon ; YOO, Shin Hye ; KIM, Miso ; KIM, Young Ae ; KANG, Beo Deul ; SHIM, Hyun-Jeong ; SONG, Eun-Kee ; KANG, Jung Hun ; KWON, Jung Hye ; LEE, Jung Lim ; LEE, Soon Nam ; MAENG, Chi Hoon ; KANG, Eun Joo ; DO, Young Rok ; CHOI, Yoon Seok ; JUNG, Kyung Hae
Supportive care in cancer, 10/2018, vol.26, n°10, p. 3479-3488

Document en ligne

Thème : Soins.

MORT ; PATIENT ; CANCER ; AIDANT NATUREL ; MEDECIN ; CONCEPT ; COREE ; FAMILLE ; OPINION PUBLIQUE ; PERCEPTION MORT

PURPOSE: Understanding the concept of a "good death" is crucial to end-of-life care, but our current understanding of what constitutes a good death is insufficient. Here, we investigated the components of a good death that are important to the general population, cancer patients, their families, and physicians.
METHODS: We conducted a stratified nationwide cross-sectional survey of cancer patients and their families from 12 hospitals, physicians from 12 hospitals and the Korean Medical Association, and the general population, investigating their attitudes toward 10 good-death components.
FINDINGS: Three components-"not be a burden to the family," "presence of family," and "resolve unfinished business"-were considered the most important components by more than 2/3 of each of the three groups, and an additional three components-"freedom from pain," "feel that life was meaningful," and "at peace with God"-were considered important by all but the physicians group. Physicians considered "feel life was meaningful," "presence of family," and "not be a burden to family" as the core components of a good death, with "freedom from pain" as an additional component. "Treatment choices' followed, "finances in order," "mentally aware," and "die at home" were found to be the least important components among all four groups.
CONCLUSION: While families strongly agreed that "presence of family" and "not be a burden to family" were important to a good death, the importance of other factors differed between the groups. Health care providers should attempt to discern each patient's view of a good death.

Origine : PubMed

Attitudes toward early palliative care in cancer patients and caregivers - a Korean nationwide survey

YOO, Shin Hye ; KIM, Miso ; YUN, Young Ho ; KEAM, Bhumsuk ; KIM, Young Ae ; KIM, Yu Jung ; SHIM, Hyun-Jeong ; SONG, Eun-Kee ; KANG, Jung Hun ; KWON, Jung Hye ; LEE, Jung Lim ; LEE, Soon Nam ; KIM, Si-Young ; KANG, Eun Joo ; DO, Young Rok ; CHOI, Yoon Seok ; JUNG, Kyung Hae
Cancer medicine, 25/03/2018, p. 1-10

Document en ligne

Thème : Soins. Cote : eD02.03

ATTITUDE ; PATIENT ; AIDANT NATUREL ; DEMARCHE PALLIATIVE ; CANCER ; COREE

Integrated early palliative care (EPC) improves quality of life and reduces psychological distress in adult patients with cancer and caregivers, but attitudes toward EPC have been poorly studied. We aimed to investigate attitudes toward EPC in a nationwide survey of patients with cancer and caregivers. From July to October 2016, we administered nationwide questionnaires examining attitudes toward EPC in patients with cancer (n = 1001) and their families (n = 1006) from 12 Korean hospitals. When an individual considered EPC unnecessary, the reasons were collected and analyzed. Factors associated with perception of EPC were examined. A majority of patients (84.5%) and caregivers (89.5%) had positive attitudes toward EPC. The most common reasons for deeming EPC unnecessary were that EPC may be an obstacle to cancer treatment (patients: 37%; caregivers: 23%; respectively) or that they were not sure if EPC is beneficial (patients: 21%; caregivers: 24%; respectively). Financial burden as a reason was more evident in caregivers (23%) than in patients (17%). Male gender, age <50, early stage, intensive care unit admission, and not believing that dying people should prepare to practice charity were associated with patients' negative attitudes. In caregivers, opposition to EPC was associated with not thinking death should be feared, not thinking people should be remembered, and lower educational level. Our findings showed that significant numbers of patients with advanced cancer and family caregivers showed positive attitudes toward EPC. However, more than 10% of participants did not consider EPC necessary. Physicians' communication with patients and caregivers and financial support could help overcome the barriers of EPC.

Origine : PubMed

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ACHARNEMENT THERAPEUTIQUE AIDANT AIDANT NATUREL ANTICIPATION ARRET THERAPEUTIQUE ATTITUDE CANCER CONCEPT CONTROLE DOULEUR COREE DEMARCHE PALLIATIVE EUTHANASIE MEDECIN MORT PATIENT

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