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문제 정의
- This study was based on a long period time with the case study participant regarding one Korean Americans’ attitudes toward end-of-life decisions.
- This study was originally designed to assess Korean American’s acculturation and their attitudes toward advance care planning.
제안 방법
- As it was mentioned before, education is the key factor to enhance the knowledge of end-of-life care decision. In addition, this study was not plan to compare distinction between Korean and Korean Americans rather, this study was plan to look for differences and similarities of attitudes of both Koreans (whether reside in Korea or America) regarding end-of-life care. In fact, sample was too small to address reliable values of Koreans and Korean Americans so that this subject needs to be investigate further with more numbers of respondents.
- The questionnaire includes scales designed to measure issues that were relevant to this study, as well as previously validated scales. Once modified and finalized, the questionnaire was translated into Korean and then back into English by an independent agency with experience in translating to ensure sameness of medical and technical terms. The comprehensibility and reliability of the survey instruments were pretested with five Korean Americans in the Los Angeles area and five Koreans in Seoul, South Korea (via international mail).
- Content and format were developed after review of relevant medical literatures. The questionnaire includes scales designed to measure issues that were relevant to this study, as well as previously validated scales. Once modified and finalized, the questionnaire was translated into Korean and then back into English by an independent agency with experience in translating to ensure sameness of medical and technical terms.
- With permission from an adult health center in California, the researcher introduced herself to the clients of the center after they had completed the mornin program and were waiting for lunch. The researcher described the study and invited them to to participate by completing the surveys : the demographic and the advance care planning survey and they were expected to take 15 to 20 minutes to complete the five pages. Those who were not interested in participating in the study were free to leave the room.
- This study has limitations such as, the participants in this study were too small convenience samples, and they might not be representative value of all Koreans or Korean Americans. In addition, due to too small groups, study findings may not be reliable and validated.
- This study was designed to compare differences between Koreans and Korean Americans regarding their awareness of end-of-life care, attitudes toward advance care planning, attitudes regarding truth telling, and preferred decision-making model. Demographic survey of this study had showed that there were significant age differences and gender.
대상 데이터
- The second group consisted of self-identified Korean adults age 65 and older residing in California. Fifty-six older adults participated in the study: 30 Koreans and 26 Korean Americans. Responses from five participants from Korea who failed to answer one or two questions on the survey were excluded from the study.
- Those respondents were sent via a self-administered questionnaire that contained demographic questions, questions about end-of-life decision making. Participants in the study were Korean men and women, 65 years of age or older, living either in Korea or California, U.S.A. Respondents who were younger than 65 years or who did not self-identify as Korean or Korean American were excluded from participation. The first group consisted of respondents to the questionnaire that was sent to adult day care centers in Korea (after obtaining permission from the persons in authority at the facilities).
- Once modified and finalized, the questionnaire was translated into Korean and then back into English by an independent agency with experience in translating to ensure sameness of medical and technical terms. The comprehensibility and reliability of the survey instruments were pretested with five Korean Americans in the Los Angeles area and five Koreans in Seoul, South Korea (via international mail). All participants were at least 65 years old but varied in gender, age, and education level.
- The sample included Korean men and women over 65 years old who either lived in Korea (herein Koreans) or had resided in the United States for more than 20 years (herein Korean Americans). The Koreans (mean=80.
- It could be from the place that the study had happened in Korea was female prevalent area. This study took the elderly health center in Seoul and class members were all females. In Korean culture, male elderly are not tending to go the places which have a lot of female elderly present.
성능/효과
- Nevertheless, majority of them had showed positive attitudes toward advance directives (12). From this study, these study findings showed that since the Korean respondents were significantly older than the Korean American respondents, the Korean respondents should be heard more about advance care planning terms than Korean American respondents. In fact, they still did not know about the actual meaning of advance care planning and none of them actually written about advance care planning while only a few of them written about living will or similar documents.
- This study showed that all Korean respondents were heard the word of “living will” or “death with dignity” but only 4% of them had actually written up a living will or a similar document while 65.2% of Korean Americans heard words of “living will” or “death with dignity” yet, 13% of them actually written a living will or a similar documents concerning end-of-life medical decisions.
후속연구
- Future research should assess whether Korean and Korean American elderly people understand the issues and mechanics of end-of-life care, such as advance directive and life-prolonging treatment. As it was mentioned before, education is the key factor to enhance the knowledge of end-of-life care decision.
- Hence, the need for more in-depth research considering the interaction of multiple variables is indicated. Future research should examine a large representative sample of Korean and Korean American older adults, including those with serious illnesses. In addition, this study finding had showed some of Korean American participants in this study were holding on to the Westernized thinking while some of them still hold on to Korean cultures.
- In addition, this study was not plan to compare distinction between Korean and Korean Americans rather, this study was plan to look for differences and similarities of attitudes of both Koreans (whether reside in Korea or America) regarding end-of-life care. In fact, sample was too small to address reliable values of Koreans and Korean Americans so that this subject needs to be investigate further with more numbers of respondents.
- Furthermore, there were several studies shown that older adults have tendency to delay the completion of advance directives to a later time and to delegate to others to make health care decisions in times of need (16,17). Therefore, for this current study, since Korean respondents were significantly older than Korean American respondents, there were possibilities that Korean participants had shown lesser autonomy than Korean American participants.
- Therefore, this study is considered preliminary report for future research.
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