혈액투석환자의 사전연명의료의향서 작성 영향요인*

Abstract

The purpose of this study was to identify the factors that influence Hemodialysis patients’ intentions to write Advanced Directives (ADs). A questionnaire was used to collect data from 165 chronic renal failure patients receiving hemodialysis treatment at two general hospitals in South Korea. The variables that were found to have a significant influence on the intention to write an AD were education level, knowledge of Ads, and attitudes toward ADs. Patients with a university degree or high school education were significantly more likely (3.35 times and 3.62 times, respectively) to write an AD than were those without a high school education. In terms of knowledge of ADs, as the score increased by 1 point out of 21, the intention to write an AD increased by 1.12 times. Regarding attitudes toward ADs, as the score increased by 1 point, the intention to write an AD increased by 1.13 times. Patients that would choose to continue dialysis treatment during the end-of-life period were less willing to write an AD than those who would stop the dialysis treatment. However, 18.5% of those willing to write an AD indicated that they would continue hemodialysis treatment during the end-of-life period. The results of this study suggest that discussions between patients, family members, and healthcare providers are required from the beginning of dialysis treatment so that these patients have the right knowledge and attitudes about ADs and can confirm their values and beliefs about end-of-life care.