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KMID : 0379220240440020053
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Journal of Korea Gerontological Society
2024 Volume.44 No. 2 p.53 ~ p.66
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Latent Classes of End-of-life Preparation and Perceptions about Dying Well among Older Adults: Comparison by Age Group
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Choi Bom-I
Park Ha-Young
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Abstract
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Although social awareness of the importance of well-dying has increased, empirical evidence for well-dying policies and programs is very scarce. Additionally, there is limited research examining whether perceptions about dying well vary by the types of end-of-life preparation.
Accordingly, this study sought to classify the end-of-life preparation among older Korean adults and verify differences in perceptions about well-dying according to subgroups. For this, older Korean adults aged 65 and above who participated in ‘2020 National Survey of Older Koreans’ were analyzed by dividing them into three groups: 5,977 young-old adults (65-74 years old), 3,333 old-old adults (75-84 years old), and 610 oldest-old adults (85 years old and above). End-of-life preparation was measured by four questions in the ritual aspect (e.g., preparing shrouds or funeral portraits), two questions in the psycho-social aspect (e.g., attending educational programs and writing a will), and two questions in the medical aspect (e.g., writing advance directives and pledging to donate organs). Perceptions about well-dying were measured using four items, assessing the importance of dying autonomously, without pain, in the company of family and acquaintances, and without burdening those around them. For statistical analysis, a three-stage latent class analysis and difference test which accounted for classification errors were conducted. As a result of the analysis, the young-old adults were classified into the ‘active preparation’ group, which showed a relatively active level of preparation, and the ‘no preparation’ group, which lacked preparation for end-of-life in all dimen sion s.
The old-old and oldest-old adults were classified into the ‘active preparation’ group and the ‘passive preparation’ group, which was limited to end-of-life preparation only in the ritual aspect. In particular, the proportion of the ‘active preparation’ group in all generations was very low, ranging from 3 to 6%. The results of the difference test on perceptions of well-dying showed that among the young-old an d old-old adults classified into the ‘active preparation’ group, the scores for the importance of each item were significantly lower compared to those of the ‘no preparation’ or the ‘passive preparation’ groups. Among the oldest-old adults, the ‘active preparation’ group regarded end-of-life companionship with family and acquaintances as less important than the ‘passive preparation’ group. The results of this study suggest that the level of end-of-life preparation among older adults in Korea, from young-old to oldest-old, remains low and is predominantly focused on the ritual aspect. Furthermore, perceptions about well-dying vary according to the types of end-of-life preparation. The findings of this study underscore the need for tailored approaches in well-dying policies and programs, such as end-of-life preparation education, that consider the heterogeneity within the older population.
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KEYWORD
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End-of-life preparation, Well-dying, Perception about well-dying, Latent Class Analysis, Person-centered approach
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