Factors Influencing Withdrawal of Life-Sustaining Treatment in Tertiary General Hospital Workers -Knowledge and Attitude of Organ Donation and Transplantation, Awareness of Death, Knowledge and Perception of Hospice Palliative Care-

Abstract

Purpose: This descriptive study was conducted to examine factors that affect hospital workers in their decision to withdraw from life-sustaining treatment, such as knowledge, attitude, and perception of organ donation, transplantation, death and hospice palliative care. Methods: A questionnaire was completed by 228 workers of a tertiary general hospital, and data were analyzed using t-test, ANOVA, and Pearson's correlation by using SPSS 21.0. Results: The subjects' knowledge of biomedical ethics awareness differed by age, education level, occupation, affiliated department, and biomedical ethics education. Their knowledge of brain death, organ donation and transplantation was positively correlated with attitudes toward tissue donation and transplantation, knowledge of hospice palliative care, and perception of hospice palliative care. Their attitudes toward tissue donation and transplantation were significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care, and withdrawal of life-sustaining treatment. Their awareness of death was significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care and withdrawal of life-sustaining treatment. The perception of hospice palliative care was significantly correlated with withdrawal of life-sustaining treatment. Factors associated with their withdrawal of life-sustaining treatment were work at the hospice ward (32.5%), attitudes toward tissue donation and transplantation and perception of hospice palliative care. Conclusion: This study has shown that work at the hospice ward, attitudes toward tissue donation and transplantation and perception of hospice palliative care were related to attitudes toward withdrawal of life-sustaining treatment. More research is needed to further develop various curriculums based on biomedical methods.

Analysis of Factors Affecting Emergency Physicians’ Attitudes toward Deceased Organ & Tissue Donation

“…According to a survey of healthcare professionals and workers in a Korean tertiary hospital, there was a significant positive correlation between the attitudes towards organ donation and the knowledge and perception of hospice palliative care. 20 This is consistent with the results of this study. However, we should be cautious in assuming that a more positive attitude toward stopping LST results in a more positive attitude toward OTD.…”

Korean nurses’ attitude towards withdrawing life sustaining treatment: A review of literature

“…Working unit: Attitude toward withdrawing life sustaining treatment differed by working unit. Participants who work in hospice care show more positive attitude toward withdrawing life sustaining treatment than those who work in Emergency room and operating room [14]. This results can be interpreted in that nurses in hospice ward experience more death and dying patients.…”

“…ICU nurses attitude toward withdrawing life sustaining treatment was 3.23 [13] and 3.33 out of 5 [9]. The home care nurses' score was 3.28 [5] and tertiary general hospital nurses' score was 3.5 out of 5 [14]. Kim & Kim study's nurses who worked in six general hospitals agreed on withdrawing life sustaining treatment and the score was 3.2 out of 5 [15].…”

“…Nurses with positive attitude toward withdrawing life sustaining treatment had higher awareness of patient determination rights [5]. There is positive correlation between attitude toward withdrawing life sustaining treatment and good death perception [14]. It can be inferred from the fact that the purpose of withdrawing life sustaining treatment is to guarantee patients' right to die with dignity.…”

“…Attitude toward withdrawing life sustaining treatment was affected by working at hospice ward, attitude about tissue donation and tissue transplantation, and awareness of hospice palliative care. Attitude toward withdrawing life sustaining treatment was explained by 32.5% by variances [14].…”