Young Ho Yun1,2,3, Kyoung-Nam Kim4, Jin-Ah Sim5, EunKyo Kang6, Jihye Lee7, Jiyeon Choo5, Shin Hye Yoo8, Miso Kim8, Young Ae Kim9, Beo Deul Kang10, Hyun-Jeong Shim11, Eun-Kee Song12, Jung Hun Kang13, Jung Hye Kwon14, Jung Lim Lee15, Soon Nam Lee16, Chi Hoon Maeng17, Eun Joo Kang18, Young Rok Do19, Yoon Seok Choi20, Kyung Hae Jung21. 1. Department of Biomedical Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, 110-799, Seoul, South Korea. lawyun@snu.ac.kr. 2. Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea. lawyun@snu.ac.kr. 3. Department of Biomedical Informatics, Seoul National University College of Medicine, Seoul, South Korea. lawyun@snu.ac.kr. 4. Public Health Medical Service, Seoul National University Hospital, Seoul, South Korea. 5. Department of Biomedical Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, 110-799, Seoul, South Korea. 6. Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea. 7. Department of Biomedical Informatics, Seoul National University College of Medicine, Seoul, South Korea. 8. Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea. 9. National Cancer Control Institute, National Cancer Center, Goyang, South Korea. 10. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea. 11. Division of Hematology and Medical Oncology, Department of Internal Medicine, Chonnam National University School of Medicine, Hwasun, South Korea. 12. Division of Hematology/Oncology, Chonbuk National University Medical School, Jeonju, South Korea. 13. Department of Internal Medicine, Postgraduate Medical School, Gyeongsang National University, Jinju, South Korea. 14. Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea. 15. Department of Hemato-oncology, Daegu Fatima Hospital, Daegu, South Korea. 16. Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, South Korea. 17. Department of Medical Oncology and Hematology, Kyung Hee University Hospital, Seoul, South Korea. 18. Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea. 19. Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea. 20. Department of Internal Medicine, Chungnam National University Hospital, Daejeon, South Korea. 21. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Abstract
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.
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, cancerpatients, their families, and physicians. METHODS: We conducted a stratified nationwide cross-sectional survey of cancerpatients 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.
Entities:
Keywords:
Attitudes toward death; Cancer; End-of-life; Good death
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