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임종기 치료에 대한 암 환자, 보호자, 그리고 의사의 수용태도

Other Titles
 Attitude of cancer patients, their primary care givers and doctors toward end-of-life care 
 심재용  ;  최윤선  ;  강용준  ;  조현상  ;  조항석 
 Journal of the Korean Academy of Family Medicine (가정의학회지), Vol.21(4) : 489-497, 2000 
Journal Title
Journal of the Korean Academy of Family Medicine(가정의학회지)
Issue Date
Attitude to death ; palliative care ; decision-making
BACKGROUND: Decision about life sustaining treatments ought to be based on the patient's informed preferences. This study was to see if there were any differences in acceptance by patients, their primary care givers and doctors for end-of-life care according to situations, and if any, to analyse the factors related with different attitudes. METHODS: A structured questionnaire survey of end-of-life care preferences was performed on 162 cancer patients and their primary care givers in four university hospitals and one general hospital from March 1, 1999 to February 29, 2000. A similar survey was done for doctors practicing at the above hospitals during the same period to investigate their attitudes toward providing end-of-life care to an assumed nearly bed-ridden patients. ANOVA, t-test and Wilcoxon rank sum test were used to compare acceptance of intervention among the groups or according to the various situations. Factors presumed to be related to the acceptance were sought and analysed by stepwise multiple regression. RESULTS: The difference in acceptance of intervention between the primary care giver group and the doctor group was not significant in almost every situation, showing significantly higher than the patient group (P<0.001). All three groups showed higher acceptance when a therapeutic intervention rather than a diagnostic test was proposed (P<0.001), when expected survival was 30 days rather than 7 (P<0.01), and when the therapeutic intervention was thought as non-invasive rather than invasive (P<0.001). The less anxious the patient was, the higher the acceptance from the patient. Patients with a religion had higher acceptance rate than non-religious patients. Primary care givers who expected cure of the disease accepted more of the postulated care than those who did not (P<0.05). Wives or mother-in-laws of patients showed lower acceptance than those in other relationship (P<0.05). The longer the patient had been diagnosed with cancer, the higher the acceptance of the primary care giver (P<0.1). Direct relatives showed higher acceptance than that of collaterals (P<0.1). Family doctors specializing in family medicine had lower acceptance than doctors of other specialties and interns (P<0.05). CONCLUSION: The acceptance of intervention by patients was lower than that of primary care givers and doctors and depended on the expected survival and the type of intervention.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Family Medicine (가정의학교실) > 1. Journal Papers
Yonsei Authors
Shim, Jae Yong(심재용) ORCID logo https://orcid.org/0000-0002-9561-9230
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