Perceptions on good‐life, good‐death, and advance care planning in Koreans with non‐cancerous chronic diseases. (22nd November 2020)

• Record Type: Journal Article
• Authors: Cha, EunSeok; Kim, JinShil; Sohn, Min Kyun; Lee, Byung Seok; Jung, Sung Soo; Lee, SoJung; Lee, Insil
• Is Part Of: Journal of advanced nursing. Volume 77:Number 2(2021)
• Page Start: 889
• Page End: 898
• Publication Date: 2020-11-22
• Subjects: advance care planning -- chronic disease -- culture -- end‐of‐life -- good‐death -- good‐life -- non‐cancerous chronic disease -- nursing -- nursing education -- qualitative research; Nursing -- Periodicals; 610.7305
• DOI: 10.1111/jan.14633
• Languages: English
• ISSNs: 0309-2402

Abstract

Abstract: Aims: This study explored perceptions on a good‐life, good‐death, and advance care planning in Koreans with non‐cancerous chronic diseases with the goal to develop a culture‐specific advance care planning intervention in this population. Design: A qualitative descriptive design was used. Methods: Data collections were conducted between September 2017 – June 2018. Twenty‐nine patients aged 41–82 years (85.8% men) participated in the interviews lasting 40–60 min. The verbatim transcriptions of the semi‐structured interview data were analysed using conventional content analysis. Results: Good‐life was described as 'present with physical and financial independence, ' 'not burdensome to the family, ' 'completed life responsibility', and 'helping others.' Some participants described good‐death as 'prepared death' while others considered it as 'sudden death during sleep.' All participants wanted to have a painless death and not burden the family. Advance care planning was a new concept to many participants. It was likened to 'insurance.' Some participants believed that decision‐making on life‐sustaining treatment should be done by their family, not themselves, because of economic or emotional distress. Some participants wanted to discuss medical and non‐medical care services to reduce the burden on self and family. Conclusion: Family is key when it comes to the meaning of good‐life and good‐death. Cultural adaptation is necessary to meet the advance care planning needs of Koreans with non‐cancerous chronic diseases. Impact: Successfully implementing advance care planning in Koreans with non‐cancerous chronic diseases depends on how it is adapted to the disease‐specific characteristics compared with cancer, and the cultural norms and social context. Nurses need to be prepared to offer advance care planning to persons with non‐cancerous chronic diseases based on a keen sense of and empathetic cultural competence. 摘要: 目的: 本研究探讨了韩国非癌症慢性疾病患者对美好生活、善终和预先护理计划的认知, 旨在对此类人群展开针对特定文化的预先护理计划干预。 设计: 运用定性描述性设计。 方法: 数据于2017年9月至2018年6月收集。共29名患者参与访谈, 患者年龄介于41‐82岁之间(85.8%为男性), 且访谈时间为40‐60分钟。现已采用传统的内容分析法, 以便对半结构化访谈数据的逐字记录进行分析。 结果: 人们认为, 美好生活 是指"身体和经济独立"、"家庭无负担"、"承担人生责任"和"帮助他人"。部分参与者将 善终 描述为"预备死亡", 而另一些人则认为善终是指"睡眠时突然死亡"。参与者们希望可以无痛死亡, 不想给家庭带来负担。 对多名参与者来说, 预先护理计划 是一个全新的概念。这项计划又称作"保险"。部分参与者认为, 患者饱受经济或情绪上的困扰, 因此, 是否维持生命治疗的决策应该由其家人而非其自身作出。部分参与者希望就医疗和非医疗保健服务展开讨论, 以减轻自身和家庭的负担。 结论: 家庭是美好生活和善终的关键。有必要适应不同文化, 以满足韩国非癌症慢性疾病患者的预先护理计划需要。 影响: 韩国非癌症慢性疾病患者的预先护理计划的成功执行取决于其如何适应相较于癌症的特定疾病病症, 以及相关文化规范和社会背景。护士应做好准备, 具备敏锐的意识和文化移情能力, 以便为非癌症慢性病患者提供预先护理计划。