Cancer Survivors' Attitude towards End-of-Life Decisions

Tuesday, 14 July 2009

Mi Hee Lee, RN
Nursing, Kangnam Sacred Heart Hospital, Seoul, South Korea
Mi Suk Kim, MS
Department of Nursing, Cung-Ang University, Seoul, South Korea
Hee Sun Kang, PhD
Department of nursing, Chung-Ang University, Seoul, South Korea

Learning Objective 1: The learner will be able to know the status of end-of-life care in Korea.

Learning Objective 2: The learner will be able to describe the concerns regarding the end-of-life decisions of cancer survivors.

Purpose: Do-Not-Resuscitation (DNR) is not legally permitted in Korea although it is being practiced for critical patients. This study was performed to identify the attitudes towards end-of-life decisions of cancer patients. Methods: A cross-sectional descriptive study was performed with a total of 137 cancer survivors from two university hospitals in Korea. The data were collected using self-administered questionnaires from Oct 13 to Nov 30, 2008 after IRB was approved. The data were analyzed using descriptive statistics. Results: Of the 137 participants, 67.16% were between 41 and 60 years old. Three most frequent cancer types among the population were breast cancer (45.07%), gastric cancer (14.79%) and lung cancer (6.65%).     The majority of the respondents (63.73%) were against life sustaining treatment believing that everyone has the right to die. Over 60% of respondents were willing to write an advance directive in an effort to express his or her wishes and to ease the burden for family members. Only 28.47% had discussed death and their wishes with their family. Almost half of the respondents (47.8%) expressed that they felt uncomfortable discussing death with family. However, they wanted their family to know their wishes in advance and respect their decisions. Majority of them (75.8%) stated that they need information on advance directives and prefer to have the information through group or individual lecture and pamphlet. Conclusion: Cancer survivors' wishes will be more respected once they communicate their wishes in advance. Since most of cancer survivors never had an opportunity to talk about their wishes with family and were willing to know more about advance directives, it is important to give them more information on end-of-life issues and help them communicate with family members and make an informed decision.