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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

  • 주제(키워드) attitudes toward death , modes of death , active pain control , passive euthanasia , active euthanasia , PAS
  • 주제(기타) Medicine, General & Internal
  • 설명문(일반) [Yun, Young Ho; Sim, Jin-Ah] Seoul Natl Univ, Dept Biomed Sci, Coll Med, Seoul, South Korea; [Yun, Young Ho] Seoul Natl Univ, Dept Biomed Informat, Coll Med, Seoul, South Korea; [Kim, Kyoung-Nam] Seoul Natl Univ Hosp, Publ Hlth Med Serv, Seoul, South Korea; [Yoo, Shin Hye; Kim, Miso] Seoul Natl Univ Hosp, Dept Internal Med, Seoul, South Korea; [Kim, Young Ae] Natl Canc Ctr, Natl Canc Control Inst, Canc Survivorship Branch, Goyang, South Korea; [Kang, Beo Deul] Seoul Natl Univ, Dept Internal Med, Bundang Hosp, Seongnam, South Korea; [Shim, Hyun-Jeong] Chonbuk Natl Univ, Sch Med, Div Hematol & Med Oncol, Dept Internal Med, Jeonju, South Korea; [Song, Eun-Kee] Chonbuk Natl Univ, Sch Med, Div Hematol Oncol, Jeonju, South Korea; [Kang, Jung Hun] Gyeongsang Natl Univ, Postgrad Med Sch, Dept Internal Med, Jinju, South Korea; [Kwon, Jung Hye] Hallym Univ, Coll Med, Dept Internal Med, Kangdong Sacred Heart Hosp, Seoul, South Korea; [Lee, Jung Lim] Daegu Fatima Hosp, Dept Hematooncol, Daegu, South Korea; [Nam, Eun Mi] Ewha Womans Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Maeng, Chi Hoon] Kyung Hee Univ Hosp, Dept Med Oncol & Hematol, Seoul, South Korea; [Kang, Eun Joo] Korea Univ, Dept Internal Med, Guro Hosp, Coll Med, Seoul, South Korea; [Do, Young Rok] Keimyung Univ, Dept Internal Med, Dongsan Med Ctr, Sch Med, Daegu, South Korea; [Choi, Yoon Seok] Chungnam Natl Univ Hosp, Dept Internal Med, Daejeon, South Korea; [Jung, Kyung Hae] Univ Ulsan, Asan Med Ctr, Dept Oncol, Coll Med, Seoul, South Korea
  • 등재 SCIE, SCOPUS
  • 발행기관 BMJ PUBLISHING GROUP
  • 발행년도 2018
  • URI http://www.dcollection.net/handler/ewha/000000156252
  • 본문언어 영어
  • Published As http://dx.doi.org/10.1136/bmjopen-2017-020519

초록/요약

Objectives This study determined attitudes of four groupsKorean patients with cancer, their family caregivers, physicians and the general Korean populationtowards five critical end-of-life (EOL) interventionsactive 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.

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