Experience of Advance Directives in a Hospice Center

공봉한; 안호정; An; 김현선; 하소영; 김일규; 이정은; 박윤정; 강이진; 김영례; 김훈교

Experience of Advance Directives in a Hospice Center

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Type: Academic journal

Author: 공봉한 안호정 An 김현선 하소영 김일규 이정은 박윤정 강이진 김영례 김훈교

Journal: 대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.30 No.2 KCI Accredited Journals

Published: 2015.1

Pages: 151 - 154 (4page)

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Experience of Advance Directives in a Hospice Center

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To protect patient autonomy when confronting death, the importance of advancedirectives (ADs) has recently became an issue and gradually accepted in Korea. However, inreal practice, ADs were not completed by patients but their families in most cases. Toanalyze the current situation of performing ADs, we reviewed medical charts of 214terminal cancer patients admitted to the hospice center from October 2012 to September2013. Seventy-six (35.5%) patients completed ADs. All ADs were completed by patientsthemselves. The most common reason for not completing ADs was poor physical and/ormental condition. As a proxy, the majority of patients preferred their spouses (55.3%). Few patients wanted life sustaining treatment (1.3%), however palliative sedation wasaccepted in 89.5%. The median timing of ADs after admission was three (0-90) days, andduration of survival since ADs was 22 (1-340) days. In conclusion, approximately one thirdof terminal cancer patients completed ADs by themselves. Considering that patient’s poorcondition is the main reason for not completing ADs, earlier discussion regarding ADs isnecessary to enhance patients’ participation.

#Advance Directives #Hospice Care #Neoplasms

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References (12)

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Brown BA / 2003 / The history of advance directives : a literature review / J Gerontol Nurs 29:4~14

허대석 / 2009 / 환자의 자기결정권과 사전의료지시서 / 대한의사협회지 52(9):865~870

손덕승 / 2009 / 호스피스병동 말기 암 환자 및 내과의사의 사전의료지시(서)에 대한 인식 / 한국호스피스완화의료학회지 12(1):20~26

Kwon SH / 2012 / Most advance directives written by patients with advanced cancer or their proxies request only minimally invasive treatments during end-of-life care / Am J Hosp Palliat Care 29:622~626

김훈교 / 2004 / 호스피스 병동에서 시행되는 말기 암 환자의 DNR 동의 / 한국호스피스완화의료학회지 7(2):232~237

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