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KMID : 1035720210220010055
Journal of Korean Society for School & Community Health Education
2021 Volume.22 No. 1 p.55 ~ p.72
Structural Equation Modeling of Advance Directive Intent among a Korean Group in their Middle-Age
Jung Young-Mi

Abstract
Objectives: The aim of this study was to construct and verify a structural equation model of advance directive intent among a Korean group in their middle-age.

Methods: Data were collected between May 1 and 30, 2017, from 398 people. The endogenous and exogenous variables of the hypothetical model consisted of elderly parents¡¯ care burden, health status, attitude towards withdrawal of life sustaining treatment, advance directive efficacy, and advance directive intent. The collected data were analyzed using the SPSS/WIN 24.0 and Mplus 7.4.

Results: The hypothetical model demonstrated a good fit: ¥ö2=223.79(df=109, p<.001), CMIN/df=2.05 CFI=.96, TLI=.96, RMSEA=.05, SRMR=.06. Elderly parents¡¯ care burden and health status showed statistically significant direct effects with attitude toward withdrawal of life sustaining treatment(¥â=.17, p=.001; ¥â=.21, p<.001) and advance directive efficacy(¥â=.11, p=.040; ¥â=.19, p=.002), respectively. Attitude toward withdrawal of life sustaining treatment and advance directive efficacy showed statistically significant direct effects on advance directive intent(¥â=.15, p=.007; ¥â=.48, p<.001). Elderly parents¡¯ care burden and health status had a significant indirect effect on advance directive intent through attitude toward withdrawal of life sustaining treatment(¥â=.01, p=.041; ¥â=.05, p=.036) and advance directive efficacy(¥â=.06, p=.049; ¥â=.16, p=.006), respectively. The variables accounted for 26.1% of advance directive intent of the Korean group in their middle-age.

Conclusion: It is necessary to develop an advance directive education program based on variables affecting advance directive intent for individuals in their middle-age.
KEYWORD
Advance Directive, Intention, Middle Aged
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