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Awareness and Attitude Change after End-of-Life Care Education for Medical Students
±èÇö°æ, ³²Àº¹Ì, ÀÌ°æÀº, À̼ø³²,
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±èÇö°æ ( Kim Hyung-Kyung )
ÀÌÈ¿©ÀÚ´ëÇб³ ÀÇÇÐÀü¹®´ëÇпø ³»°úÇб³½Ç
³²Àº¹Ì ( Nam Eun-Mi )
ÀÌÈ¿©ÀÚ´ëÇб³ ÀÇÇÐÀü¹®´ëÇпø ³»°úÇб³½Ç
ÀÌ°æÀº ( Lee Kyung-Eun )
ÀÌÈ¿©ÀÚ´ëÇб³ ÀÇÇÐÀü¹®´ëÇпø ³»°úÇб³½Ç
À̼ø³² ( Lee Soon-Nam )
ÀÌÈ¿©ÀÚ´ëÇб³ ÀÇÇÐÀü¹®´ëÇпø ³»°úÇб³½Ç
KMID : 0856920120150010030
Abstract
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¹æ¹ý: ÀÌÈ¿©ÀÚ´ëÇб³ ÀÇÇÐÀü¹®´ëÇпø ÀÇÇаú 4Çгâ Çлý 166¸íÀ» ´ë»óÀ¸·Î ¸»±âȯÀÚÀÇ È£½ºÇǽº ¿ÏÈÀÇ·á¿¡ °üÇÑ ¼³¹®Á¶»ç¸¦ ±³À° Àü°ú ÈÄ¿¡ Á¶»çÇÏ¿© ºÐ¼®ÇÏ¿´´Ù.
°á°ú: »çÀüÀÇ·áÀÇÇâ¼ ÀÛ¼º½Ã±â¿¡ °üÇÑ Áú¹®¿¡ ±³À° Àü¿¡´Â ¡¯ÀÓÁ¾ÀÌ °¡±î¿î ¸»±â¡¯°¡ 33.6%·Î °¡Àå ºóµµ°¡ ³ô¾ÒÀ¸³ª ±³À° ÈÄ¿¡´Â ¡¯°Ç°ÇÒ ¶§¡¯°¡ 58.7%·Î °¡Àå ¸¹¾Ò´Ù. ¹«ÀǹÌÇÑ ¿¬¸íÄ¡·áÀÇ À¯º¸³ª ÁßÁö¿¡ °üÇÏ¿©´Â ¼ö¾÷ Àü°ú ÈÄ¿¡ ½ÉÆó¼Ò»ý¼úÀº 48.1% ´ë 92.5%, ±â°ü»ð°üÀ̳ª ÀΰøÈ£Èí±â 38.3% ´ë 92.5%, Ç÷¾Ð»ó½ÂÁ¦ 39.1% ´ë 85.8%, Ç÷¾×Åõ¼® 60.9% ´ë 94.8%, ÃÑÁ¤¸Æ¿µ¾ç°ø±Þ 27.8% ´ë 56.0%·Î À¯ÀÇÇÑ º¯È¸¦ º¸¿´´Ù. ¾È¶ô»ç¿¡ ´ëÇÑ ¹Ý´ë ÀÇ»ç´Â 46.6%¿¡¼ 82.1%·Î ÇöÀúÈ÷ Áõ°¡ÇÏ¿´´Ù. ¸ðµç ÇлýÀÌ ¸»±âȯÀÚ µ¹º½ ±³À°ÀÌ ÇÊ¿äÇÏ´Ù°í µ¿ÀÇÇÏ¿´´Ù.
°á·Ð: ´ëºÎºÐÀÇ ÀÇ°ú´ëÇлýÀº ÀÓÁ¾È¯ÀÚ°ü¸® ±³À°°úÁ¤À» ÅëÇØ Á×À½ÀÇ Àǹ̿¡ ´ëÇØ ¼ºÂûÇÏ´Â ½Ã°£À» °®°í ¸»±âȯÀÚÀÇ È£½ºÇǽº ¿ÏÈÀÇ·á ±³À°ÀÇ Çʿ伺À» ÀνÄÇÏ¿´´Ù. ¶ÇÇÑ ¸»±âȯÀÚÀÇ µ¹º½¿¡ °üÇÑ Àνİú ŵµÀÇ º¯È°¡ ÄÇ´Ù. ÇâÈÄ ÀÌ·¯ÇÑ ±³À°°úÁ¤ÀÌ ¸ðµç ÀÇ°ú´ëÇп¡¼ Á¤±Ô±³À°°úÁ¤À¸·Î Æ÷ÇԵǾî¾ß ÇÒ °ÍÀÌ´Ù.
Purpose: Most medical schools in Korea do not provide adequate education in end-of-life care. This study was designed to illustrate the need to improve end-of-life care education and to assess the effect of the education on fourth-year medical students¡¯ awareness and attitude towards hospice and palliative care for terminally ill patients.
Methods: One hundred sixty six fourth-year medical students were surveyed with questionnaires on end-of-life care before and after they received the education.
Results: Before receiving the education, students most frequently answered "at the end of life" (33.6%) was appropriate time to write an advance medical directive. After the education, the most frequent answer was "in healthy status" (58.7%). More students agreed to withholding or withdrawing futile life-sustaining treatment increased after the education (48.1% vs. 92.5% (P<0.001) for cardiopulmonary resuscitation, 38.3% vs. 92.5% (P<0.001) for intubation and mechanical ventilation, 39.1% vs. 85.8% (P<0.001) for inotropics, 60.9% vs. 94.8% (P<0.001) for dialysis and 27.8% vs. 56.0% (P<0.001) for total parenteral nutrition). Significantly more students opposed euthanasia after the education (46.6% vs. 82.1%, P<0.001). All students agreed to the need for education in end-of-life care.
Conclusion: After reflecting on the meaning of death through the end-of-life care education, most students recognized the need for the education. The education brought remarkable changes in students¡¯ awareness and attitude towards patients at the end of life. We suggest end-of-life care education should be included in the regular curriculum of all medical schools in Korea.
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¸»±âȯÀÚ µ¹º½; ±³À°; È£½ºÇǽº; ¿ÏÈÀÇ·á
Terminal care; Curriculum; Hospice care; Palliative care
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