임종기 연명치료 중단관련 특성과 사전의료의향서에 대한 노인환자의 태도
Characteristics of End of Life Sustaining Treatment and Attitudes towards Advance Directives among Geriatric Patients
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초록
목적: 이 연구의 목적은 연명치료의 특성과 노인환자의 사전의료의향서에 대한 태도를 파악 하기 위함이다. 방법: 2012년 10월 30일 부터 2013년 3월 31일 까지 146명의 노인 환자를 대상으로 하였다. 질문의 내용에는 환자의 특성, 연명치료와 관련된 경험, 사전의료의향서 에 대한 태도를 포함했다. 자료는 SPSS 17을 사용하여 분석되었다. 결과: 대상자들은 사전 의료의향서에 호의를 보였다. 대상자들은 급성 심정지 시 심폐소생술(78.8%)과 통증조절약 물(74.0%)을 선호했지만, 연명치료를 위한 기관절개술(96.6%)과 산호호흡기의 사용(87.0%) 은 거부했다. 가족이 있거나 심폐소생술에 대한 인식이 있는 대상자(t=2.14, p=.043) 또는 가족들과 임종기 연명치료에 대해 이야기 하고 인식이 있는 대상자(t=3.29, p=.001) 또는 이미 연명 치료를 받기를 거부한 대상자(t=3.18, p=.002)는 그렇지 않는 대상자보다 사전의 료의향서를 선호했다. 결론: 이 연구는 연명치료와 사전의료의향서에 대한 노인환자의 태도 에 대한 정보를 제공한다. 임종기 사전의료의향서에 대한 교육 프로그램이 노인환자가 사전 에 연명치료에 대한 결정을 하는데 도움을 줄 수 있을 것이다.
Abstract
Purpose: The purpose of this study was to identify the characteristics of life-sustaining treatment and attitudes towards advance directives among geriatric patients. Methods: The elderly participants (N=146) were recruited from a university hospital from October 30, 2012 to March 31, 2013. A questionnaire for collecting data of participants’ characteristics, their experiences related to life-sustaining treatment, and attitudes towards advance directives was used. The data were analyzed using SPSS WIN 17. Results: Most participants (84.9%) were in favor of advance directives. Although most of participants wanted to receive CPR for sudden cardiac arrest (78.8%) and pain control medication (74.0%), most preferred to refuse life-sustaining treatments such as tracheostomy (96.6%) or ventilator (87.0%). Participants who had a family or acquaintances with CPR experiences (U=852.00 p=.038), had discussed with their family and acquaintances regarding end-of-life sustaining treatment (t=2.91, p=.004), or made decisions about refusing the life sustaining treatments (t=3.19, p=.002) preferred to have advance directives than those who did not. Conclusion: The findings of this study suggested the potential benefits of educational programs about advance directives for the end-of-life for geriatric patients to make decisions for life-sustaining treatments in advance.
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