Kim Shinmi, Lee Yunjung
Department of Nursing, Woosuk University, Chonbuk, South Korea.
Nurs Ethics. 2003 Nov;10(6):624-37. doi: 10.1191/0969733003ne652oa.
This study was an investigation of which distinctive elements would best describe good and bad death, preferences for life-sustaining treatment, and advance directives. The following elements of a good death were identified by surveying 185 acute-care hospital nurses: comfort, not being a burden to the family, a good relationship with family members, a readiness to die, and a belief in perpetuity. Comfort was regarded as the most important. Distinctive elements of a bad death were: persistent vegetative state, sudden death, pain and agony, dying alone, and being a burden to the family. Of the 185 respondents, 90.8% answered that they did not intend to receive life-sustaining treatment if they suffered from a terminal illness without any chance of recovery; 77.8% revealed positive attitudes toward advance directives. Sixty-seven per cent of the respondents stated that they were willing to discuss their own death and dying; the perception of such discussions differed according to the medical condition (p = 0.001). The elements of a bad death differed significantly depending on the disease state (p = 0.003) and on economic status (p = 0.023).
本研究旨在调查哪些独特因素最能描述善终与恶终、维持生命治疗的偏好以及预立医疗指示。通过对185名急症医院护士进行调查,确定了善终具有以下因素:舒适、不给家人造成负担、与家庭成员关系良好、坦然面对死亡以及相信永恒。舒适被视为最重要的因素。恶终的独特因素包括:持续性植物状态、猝死、疼痛与痛苦、孤独离世以及给家人造成负担。在185名受访者中,90.8%的人表示如果身患绝症且毫无康复希望,他们不打算接受维持生命的治疗;77.8%的人对预立医疗指示持积极态度。67%的受访者表示愿意讨论自己的死亡;对这类讨论的看法因医疗状况而异(p = 0.001)。恶终的因素因疾病状态(p = 0.003)和经济状况(p = 0.023)而有显著差异。