Effect of end-of-life care education using humanistic approach in Korea.

The essential concept of hospice and palliative care nursing is a humanistic approach to patient care. The purpose of this study was to examine the effects of a humanistic end-of-life care course on South Korean undergraduate nursing students' attitudes toward death, death anxiety, and communication skills. A nonequivalent control group design was used. Thirty-nine students from two universities were allocated to the control (n = 20) and experimental (n = 19) groups. Participants in the experimental group were enrolled in an end-of-life care course that utilized humanistic approach two hours per week for 16 weeks. The data were analyzed using the SPSS WIN 17.0. Attitudes toward death and communication skills in the experimental group were found to have increased compared with those of the control group. In conclusion, the humanistic end-of-life care course is effective in reducing negative attitudes toward death and increasing the communication skills of Korean nursing students.

Effects of an educational programme on shared decision-making among Korean nurses.

This study was conducted to examine the effects of an educational programme on shared decision-making on end-of-life care performance, moral sensitivity and attitude towards shared decision-making among Korean nurses. A quasi-experimental study with a non-equivalent control group pretest-posttest design was used. Forty-one clinical nurses were recruited as participants from two different university hospitals located in Daegu, Korea. Twenty nurses in the control group received no intervention, and 21 nurses in the experimental group received the educational programme on shared decision-making. Data were collected with a questionnaire covering end-of-life care performance, moral sensitivity and attitude towards shared decision-making. Analysis of the data was done with the chi-square test, t-test and Fisher's exact test using SPSS/Win 17.0 (SPSS, Inc., Chicago, IL, USA). The experimental group showed significantly higher scores in moral sensitivity and attitude towards shared decision-making after the intervention compared with the control group. This study suggests that the educational programme on shared decision-making was effective in increasing the moral sensitivity and attitude towards shared decision-making among Korean nurses.

Qualitative content analysis experiences with objective structured clinical examination among Korean nursing students.

AIM: The aim of this study was to explore the experiences of Korean nursing students with an objective structured clinical examination (OSCE) assessment regarding the 12 cranial nerves using qualitative content analysis. METHODS: Qualitative content analysis was used to explore the subjective experiences of nursing baccalaureate students after taking the OSCE. Convenience sampling was used to select 64 4th year nursing students who were interested in taking the OSCE. The participants learned content about the 12 cranial nerve assessment by lectures, demonstrations, and videos before the OSCE. The OSCE consisted of examinations in each of three stations for 2 days. The participants wrote information about their experiences on sheets of paper immediately after the OSCE anonymously in an adjacent room. The submitted materials were analyzed via qualitative content analysis. RESULTS: The collected materials were classified into two themes and seven categories. One theme was "awareness of inner capabilities", which included three categories: "inner motivation", "inner confidence", and "creativity". The other theme was "barriers to nursing performance", which included four categories: "deficiency of knowledge", "deficiency of communication skill", "deficiency of attitude toward comfort", and "deficiency of repetitive practice". CONCLUSION: This study revealed that the participants simultaneously experienced the potential and deficiency of their nursing competency after an OSCE session on cranial nerves. OSCE also provided the opportunity for nursing students to realize nursing care in a holistic manner unlike concern that OSCE undermines holism.

Factors affecting shared decision making at end of life in Korean adults.

The purpose of this study was to explore the factors affecting shared decision making among Korean adults. Attitudes toward advance directives and withdrawal of life-sustaining treatment explained 45.0% of shared decision making, suggesting that these 2 factors influence shared decision making in end-of-life care.

A Q methodological study on Korean nurses' attitudes toward forgiveness.

The purpose of this study was to identify the perceived attitudes of Korean nurses toward forgiveness on the basis of their social and cultural background. Q methodology was used to explore the typology of perceived attitudes. Four types of attitudes toward forgiveness were identified: obstinate, concessive, progressive, and receptive.

[Effect of family cohesion, subjective happiness and other factors on death anxiety in Korean elders].

PURPOSE: The purposes of this study were to explore the effects of family cohesion and subjective happiness on death anxiety of Korean elders and to identify other factors contributing to death anxiety. METHODS: The participants were 280 elders who lived in P metropolitan city. Data were collected between November 5, 2011 and January 12, 2012 using the Short Portable Mental Status Questionnaire (SPMSQ), Family Cohesion Evaluation Scale, Subjective Happiness Scale, and Fear of Death Scale (FODS). Data were analyzed using the SPSS/WIN 19.0 program. RESULTS: Family cohesion, marital status, religious activity, perceived health status, and subjective happiness were included in the factors affecting death anxiety of Korean elders. These variables explained 50.1% of death anxiety. CONCLUSION: The results of the study indicate that these variables should be considered in developing nursing intervention programs to decrease death anxiety and increase family cohesion and subjective happiness for life integration in Korean elders.

Family factors affecting on withdrawal of life-sustaining treatment in Korea.

The purpose of this study was to identify the family factors affecting on withdrawal of life-sustaining treatment in Korea on the basis of Olson's Circumplex Model. A descriptive study was conducted with 364 Korean adults who had experienced a family member with cancer being hospitalized at least 1 month prior in Korea. Data were analysed by using the Pearson's correlation coefficient and multiple regressions with SPSS/WIN 15.0 program. The mean score of The mean score of withdrawal of life-sustaining treatment appeared low. Significant bivariate correlations were found among withdrawal of life-sustaining treatment, family cohesion and family communication. Family factors predicting withdrawal of life-sustaining treatment were family cohesion and family communication. This study demonstrated that balanced families with optimal family cohesion and communication are predicted to easily accept withdrawal of life-sustaining treatment for their family member at the terminal stage in Korea.

[Development and evaluation of shared medical decision-making scale for end-of-life patients in Korea].

PURPOSE: The study was done to develop a shared decision-making scale for end-of-life patients in Korea. METHODS: The process included construction of a conceptual framework, generation of initial items, verification of content validity, selection of secondary items, preliminary study, and extraction of final items. The participants were 388 adults who lived in one of 3 Korean metropolitan cities: Seoul, Daegu, or Busan. Item analysis, factor analysis, criterion related validity, and internal consistency were used to analyze the data. Data collection was done from July to October 2011. RESULTS: Thirty-four items were selected for the final scale, and categorized into 7 factors explaining 61.9% of the total variance. The factors were labeled as sharing information (9 items), constructing system (7 items), explanation as a duty (5 items), autonomy (4 items), capturing time (3 items), participation of family (3 items), and human respect (3 items). The scores for the scale were significantly correlated among shared decision-making scale, terminating life support scale, and dignified dying scale. Cronbach's alpha coefficient for the 34 items was .94. CONCLUSION: The above findings indicate that the shared decision-making scale has a good validity and reliability when used for end-of-life patients in Korea.

Attitudes of Korean adults towards human dignity: a Q methodology approach.

AIM: The aim of this study was to identify the perceived attitudes of Korean adults towards human dignity in order to determine the relationship of human dignity to its social and cultural background. METHODS: The Q methodology research technique was used to explore perceived attitude typology on the basis of the respondents' ranking order for different statements. A convenience sampling method was used to select 40 Korean adults who were interested in human dignity to create statements. From the questionnaires, in-depth interviews, and a literature review, a total of 158 statements was obtained. The final 34 Q samples were selected from a review by two nursing professors and a Q methodology expert. Moreover, 38 respondents participated as P samples by sorting 34 Q statements on a nine-point normal distribution scale. The data were analyzed by using the QUANL software package. RESULTS: The following four types of attitudes about human dignity were identified in Korea: a happiness-oriented-self-pursuit type, relationship-oriented-self-recognition type, reflection-oriented-self-unification type, and discrimination-oriented-self-maintenance type. CONCLUSIONS: The results indicate that approaches to developing human dignity education need to take this typology into account and the characteristics of the participants who fall into each category. These results provide general guidelines to understand Korean values for professional practice in various healthcare settings.

Death metaphors in Korean undergraduate nursing students.

The purpose of this study was to understand the meaning of death metaphors seen by 133 undergraduate nursing students through open questionnaires and collage artworks, using qualitative content analysis in Korea. The 4 themes emerged: "rest-physical," "fear-psychological," "separating-social," and "new life-spiritual."

Perception of aging among Korean undergraduate nursing students

OBJECTIVE: To explore perceptions of aging among Korean undergraduate nursing students. METHODS: The participants for the study were 102 undergraduate nursing students, selected from two universities in Korea. The questions were non-structured, open-ended in order for the students to make sufficiently complete statements regarding their experiences with aging. RESULTS: The collected materials were classified into 4 themes, 13 sub-themes and 30 meaning units. Four themes emerged: fullness, emptiness, transference, and desirability. Most nursing students perceived aging positively as fullness and desirability, which are influenced by Confucianism. CONCLUSION: In conclusion, Confucianism as a cultural context should be considered to develop strategies for promoting a positive perception of aging in Korea.

OBJETIVO: Explorar a percepção sobre envelhecimento entre alunos de graduação em Enfermagem de duas universidades da Coréia do Sul. MÉTODOS: Pesquisa de abordagem qualitativa, do tipo descritivo com amostra de 102 graduandos em Enfermagem, selecionados com base em duas universidades desse país. As cinco questões utilizadas na pesquisa foram abertas, não estruturadas para possibilitar que os estudantes relatassem de modo completo suas experiências sobre envelhecimento; os relatos, obtidos entre os meses de setembro e novembro de 2010, foram submetidos à análise de conteúdo. RESULTADOS: Os materiais coletados foram classificados em quatro temas: plenitude, vazio, transferência e conveniência. A maioria dos estudantes de enfermagem percebeu o envelhecimento de forma positiva em relação à plenitude e conveniência, que são influenciados por valores do confucionismo. CONCLUSÃO: O confucionismo deve ser considerado como um contexto cultural para desenvolver estratégias de promoção de percepção positiva do envelhecimento na Coréia do Sul.

OBJETIVO: Explorar la percepción sobre el envejecimiento entre alumnos de pregrado en Enfermería de dos universidades de Corea del Sur. MÉTODOS: Investigación con abordaje cualitativo, de tipo descriptivo realizado con una muestra de 102 graduandos en Enfermería, seleccionados en dos universidades de ese país. Las cinco preguntas utilizadas en la investigación fueron abiertas, no estructuradas para posibilitar que los estudiantes relaten de modo completo sus experiencias sobre envejecimiento; los relatos, obtenidos entre los meses de setiembre y noviembre del 2010, fueron sometidos al análisis de contenido. RESULTADOS: Los materiales recolectados fueron clasificados en cuatro temas: plenitud, vacío, transferencia y conveniencia. La mayoría de los estudiantes de enfermería percibió al envejecimiento de forma positiva en relación a la plenitud y conveniencia, que son influenciados por valores del confucionismo. CONCLUSIÓN: El confucionismo debe ser considerado como un contexto cultural para desarrollar estrategias de promoción de percepción positiva del envejecimiento en Corea del Sur.

Nursing interventions to promote dignified dying in South Korea.

PURPOSE: This descriptive study aimed to assess the appropriateness of the International Classification for Nursing Practice (ICNP) catalogue Palliative Care for Dignified Dying for palliative care nursing interventions in South Korea. METHODS: The study surveyed 213 South Korean nurses who might regularly care for dying patients. Nurses were recruited to complete a survey that included interventions from the ICNP catalogue listed with Likert response sets. FINDINGS: All of the interventions were scored as being at least 'slightly important' on average. The following three nursing interventions were ranked as most important when caring for dying patients: establish trust, establish rapport, and administer pain medication. CONCLUSIONS: The study provides new insights into the palliative care provided in South Korea by documenting nurses' views of what are the most important palliative care nursing interventions. It also suggests that the palliative care interventions listed in the ICNP catalogue Palliative Care for Dignified Dying are in congruence with the interventions that nurses in South Korea use.

[Development and evaluation of a dignified dying scale for Korean adults].

PURPOSE: The study was done to develop a dignified dying scale for Korean adults. METHODS: The process included construction of a conceptual framework, generation of initial items, verification of content validity, selection of secondary items, preliminary study, and extraction of final items. The participants were 428 adults who lived in one of 3 Korean metropolitan cities: Seoul, Daegu, and Busan. Item analysis, factor analysis, criterion related validity, and internal consistency were used to analyze the data. Data collection was done from March to June 2010. RESULTS: Thirty items were selected for the final scale, and categorized into 5 factors explaining 54.5% of the total variance. The factors were labeled as maintaining emotional comfort (10 items), arranging social relationship (9 items), avoiding suffering (3 items), maintaining autonomous decision making (4 items), and role preservation (4 items). The scores for the scale were significantly correlated with personal meanings of death scale. Cronbach's alpha coefficient for the 30 items was .92. CONCLUSION: The above findings indicate that the dignified dying scale has a good validity and reliability when used with Korean adults.

Qualitative content analysis of suicidal ideation in Korean college students.

The suicide rate for ages 15-24 increased recently in South Korea. The purpose of this study was to understand the suicidal ideation using the qualitative content analysis in South Korean college students. The data were collected with non-structured open questions in 134 college students and were analyzed with qualitative content analysis. The collected materials were classified 2 categories, 6 themes, and 21 theme clusters. Two categories are emerged: (1) facilitators of suicidal ideation, and (2) inhibitors of suicidal ideation. This study identified that the facilitators of suicidal ideation are physical, psychological and societal concerns, and suggested that the inhibitors of suicidal ideation are influenced by religious and cultural context. These results presented that Buddhism and Confucianism had influence on reasons to not attempting suicide behavior as the inhibitor of suicidal ideation. In conclusion, cultural context should be considered to develop strategies for the suicide prevention in South Korean college student.

Understanding the meaning of human dignity in Korea: a content analysis.

This study aims to understand the meaning of human dignity among adults in Korea. A qualitative study design is utilized. Data were collected with non-structured questions in a sample of 74 Korean adults and analyzed with qualitative content analysis. There were 4 categories, 31 themes and 106 theme clusters classified. The four categories that emerged were: fullness of dignity; loss of dignity; reinforcement of dignity; and enfeeblement of dignity. The results of this study may contribute to healthcare professionals understanding of Korean adults human dignity.

[Factors related to life satisfaction in young-old, old, and oldest-old women].

PURPOSE: The purpose of this study was to investigate the level of life satisfaction and the significant factors which impact on life satisfaction of young-old (60-69 yr), old (70-79 yr), and oldest-old (80 yr or above) women. METHODS: The participants for this study were 289 elderly Korean women living in the city of Daegu and Kyongpook province. The data were collected using structured questionnaires. ANOVA, Chi-square, and multiple regression with the SPSS program were used to analyze the data. RESULTS: There were statistically significant differences among young-old, old, and oldest-old women regarding the existence of spouse, income, educational status, and religions. The model including variables related to physical, psychological, financial, and social aspects of life, explained variance of life satisfaction of elderly women differently, such as 55% of young-old, 37% of old, and 66% of oldest-old. Finally, self-esteem was the only predictor in explaining the level of life satisfaction among old women regardless age. CONCLUSION: Based on the findings of the study, implications for practical services for elderly women and recommendations of further study are provided. Nursing interventions should be developed to improve life satisfaction of elderly women according to age differences.

The perception of good death among human services students in South Korea: a Q-methodological approach.

The purpose of this study was to examine the subjective opinions of Korean college students about good death. Q methodology was used to analyze 34 Q-statements from 37 respondents who majored in social work, nursing, or education at a university in South Korea. With the use of a PC-QUANL software package, 4 types of perceptions about good death were identified. They are: (1) a resolute acceptance type; (2) a reasonable, natural lifespan type; (3) a relational, sentimental type; (4) and an altruistic, satisfied type. Results of this study indicate that approaches to death education need to be differentiated to take into account this typology and the characteristics of the students that fall into each category.

[A phenomenological study on the experience of hurt and forgiveness of clinical nurses in Korea after loss of employment].

PURPOSE: The purpose of this study was to understand and analyze the experience of hurt and forgiveness of clinical nurses in Korea. METHODS: A phenomenological research method guided data collection and analysis. The subjects were a total of 5 nurses who had experienced hurt and forgiveness. Data was collected through individual in-depth interviews. All interviews were audio taped and transcribed verbatim. Coding was used to establish different concepts and categories. RESULTS: The following three common constituents have been found as a retrospective focus based on the primary hurt related to the clinical situation; recognizing their personal values, obtaining their view about forgiveness, as well as their view of self. CONCLUSION: The results of this study may contribute to health professionals working in various clinical settings to understand Korean nurses with hurt and forgiveness experiences.

[Development and application of a multidimensional suicide prevention program for Korean elders by utilizing a community network].

PURPOSE: The purpose of this study was to develop a multidimensional suicide prevention program for Korean elders by utilizing a community network and to evaluate its effect. METHODS: A non-equivalent control group pretest-posttest design was used. The subjects were recruited from two different elderly institutions located in D city and K province, Korea. Nineteen subjects in the control group received no intervention and 20 subjects in the experimental group received a multidimensional suicide prevention program. RESULTS: There were more significant decreases in depression, suicide ideation, and increases in life satisfaction in the experimental group compared to the control group. CONCLUSION: According to the above results, the multidimensional suicide prevention program for Korean elders decreased stressful events like depression, and suicide ideation and increased life satisfaction through the community network. These findings suggest that this program can be used as an efficient intervention for elders in a critical situation.

[Relationship between self-efficacy, depression, level of satisfaction and death attitude of college students].

PURPOSE: The purpose of this study was to identify the relationship among self-efficacy, depression, life satisfaction and death attitude of college students. METHODS: The subjects consisted of 232 college students. Data were collected by self-reported questionnaires, which were constructed to include self-efficacy, depression, satisfaction with life, and death attitude. Data were analyzed by the SPSS/PC WIN. 12.0 program. RESULTS: Death attitude and life satisfaction of college students were significantly different according to frequency of death ideation. Death attitude for college students correlated with self-efficacy, depression, and life satisfaction. The most significant predictor of death attitude for college students was life satisfaction. CONCLUSION: The above findings indicate that death attitude for college students is influenced by self-efficacy, depression, and life satisfaction. These findings suggest that a death education program to improve life satisfaction and to give a positive attitude toward death is needed for college students.