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논문분류	춘계학술대회 초록집
제목	Attitudes toward advance care plan and hemodialysis as a life-sustaining therapy in hemodialysis patients
저자	Jangwook Lee, CY Lim, Jae Yoon Park, Seong Eun Nam, Hyo Jin Kim, Kyung Soo Kim, Sung Joon Shin
출판정보	2019; 2019(1):
키워드	hemodialysis \| life sustaining therapy \| End of Life Care
초록	Act on hospice and palliative care and decisions on life-sustaining treatment for patients at the end of life (Act on End-of-Life Care) came into effect on February 4th, 2018 in South Korea. Even though hemodialysis is one of life-sustaining treatments that can be withhold or withdrawn, the perspectives of hemodialysis patients about Act on End-of-Life Care has not been thoroughly investigated. The aim of the study is to evaluate the attitudes of maintenance hemodialysis patients toward advance care plan and hemodialysis as a life-sustaining therapy. A semi-structured interview was conducted on 27 hemodialysis patients. The interviews took place at a pre-scheduled date and time in a quiet room at the hemodialysis unit between July 2018 and February 2019. Twenty seven subjects (11 women), with a mean age of 59 years, participated in the study. Most of them (77%) answered they heard about Act on End-of-Life Care but only four (14%) knew exactly that hemodialysis belonged to life-sustaining treatments based on the Act. Sixteen subjects (59%) hoped to make end-of-life care decisions by themselves. Only six patients (22%) wanted a physician in charge to make the decision on behalf of them. Even though more than half of them (74%) did not discuss about end-of-life care with their family, they wanted their family to make the decision in case of unconsciousness. Eighteen subjects (66%) wanted to withhold hemodialysis near the end of life. The degree of prior knowledge of advance care plan was associated with increasing willingness to complete advance directives. To improve the quality of end-of-life care of maintenance hemodialysis patients, more efforts should be made to reveal and understand their perspectives and attitudes toward advance care plan and hemodialysis as a life-sustaining therapy.
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