Hye Yoon Park1, Young Ae Kim2, Jin-Ah Sim3, Jihye Lee4, Hyewon Ryu5, Jung Lim Lee6, Chi Hoon Maeng7, Jung Hye Kwon8, Yu Jung Kim9, Eun Mi Nam10, Hyun-Jeong Shim11, Eun-Kee Song12, Kyung Hae Jung13, Eun Joo Kang14, Jung Hun Kang15, Young Ho Yun16. 1. Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea. 2. National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea. 3. Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. 4. Department of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Republic of Korea. 5. Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea. 6. Department of Hemato-oncology, Daegu Fatima Hospital, Daegu, Republic of Korea. 7. Department of Medical Oncology and Hematology, Kyung Hee University Hospital, Seoul, Republic of Korea. 8. Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea. 9. Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 10. Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea. 11. Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea. 12. Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea. 13. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 14. Division of Hemato-Oncology, Department of Internal Medicine, Korea University College of Medicine, Korea University Guro Hospital, Seoul, Republic of Korea. 15. Department of Internal Medicine, Postgraduate Medical School, Gyeongsang National University, Jinju, Republic of Korea. 16. Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Health Policy and Management, Seoul National University, Seoul, Seoul, Republic of Korea. Electronic address: lawyun@snu.ac.kr.
Abstract
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: The objective of this study was 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: 1001 cancer patients, 1006 family caregivers, 928 physicians, and 1241 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 health care, as well as systematic support provisions are needed.
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: The objective of this study was 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: 1001 cancerpatients, 1006 family caregivers, 928 physicians, and 1241 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 health care, as well as systematic support provisions are needed.
Authors: Diah Martina; Olaf P Geerse; Cheng-Pei Lin; Martina S Kristanti; Wichor M Bramer; Masanori Mori; Ida J Korfage; Agnes van der Heide; Judith Ac Rietjens; Carin Cd van der Rijt Journal: Palliat Med Date: 2021-09-06 Impact factor: 4.762