KMID : 0191120150300020151
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Journal of Korean Medical Science 2015 Volume.30 No. 2 p.151 ~ p.154
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Experience of Advance Directives in a Hospice Center
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Kong Bong-Han
An Ho-Jung Kim Hyun-Seon Ha So-Young Kim Il-Kyu Lee Jung-Eun Park Youn-Jung Kang Yi-Jin Kim Young-Rye Kim Hoon-Kyo
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Abstract
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To protect patient autonomy when confronting death, the importance of advance directives (ADs) has recently became an issue and gradually accepted in Korea. However, in real practice, ADs were not completed by patients but their families in most cases. To analyze the current situation of performing ADs, we reviewed medical charts of 214 terminal cancer patients admitted to the hospice center from October 2012 to September 2013. Seventy-six (35.5%) patients completed ADs. All ADs were completed by patients themselves. The most common reason for not completing ADs was poor physical and/or mental condition. As a proxy, the majority of patients preferred their spouses (55.3%). Few patients wanted life sustaining treatment (1.3%), however palliative sedation was accepted in 89.5%. The median timing of ADs after admission was three (0-90) days, and duration of survival since ADs was 22 (1-340) days. In conclusion, approximately one third of terminal cancer patients completed ADs by themselves. Considering that patient's poor condition is the main reason for not completing ADs, earlier discussion regarding ADs is necessary to enhance patients' participation.
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KEYWORD
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Advance Directives, Hospice Care, Neoplasms
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