Effect of the Awareness of a Good Death and Perceptions of Life-sustaining Treatment Decisions on Attitudes of Intensive Care Nurses toward Terminal Care

Abstract

Purpose The purpose of this study was to identify the extent to which intensive care unit (ICU) nurses’ perceptions of life-sustaining treatment decisions and “a good death” affect attitudes toward terminal care. Method Participants included 109 ICU nurses from three university hospitals. Data were collected using structured questionnaires, and collected data were analyzed using a t-test, ANOVA, the Scheffé test, Pearson correlation coefficients, and a multiple regression analysis (SPSS 24.0 program). Results Perceptions of life-sustaining treatment decisions and a sense of closeness (a constituent for the awareness of “a good death”) were positively correlated with terminal care attitudes. The factors affecting terminal care attitudes were a clinical career in ICU (β =.20, p =.035), a sense of closeness(β =.19, p =.041), and the perception of a lifesustaining treatment decision (β =.22, p =.017). This finding indicates that more than 10 years of experience in ICU, a greater sense of closeness, and a higher view of life-sustaining treatment decisions results in more positive attitudes toward terminal care. The explanatory power of these variables on terminal care attitudes was 14% (F=6.84, p < .001, Adj R2=.140). Conclusion A sense of closeness and the perception of life-sustaining treatment decisions were identified as the factors affecting terminal care attitudes. Thus, various programs must be developed to raise awareness among ICU nurses of “a good death” and perceptions of life-sustaining treatment decisions. Key Words: Intensive care unit, Death, Terminal care, Attitude 주요어: 중환자실, 죽음, ì—°ëª ì¹˜ë£Œ, ìž„ì¢ ê°„í˜¸