Purpose: The purpose of this systematic review and meta-analysis was to investigate the effects of advance care planning on end-of-life decision-making. Methods: Databases including RISS, KISS, KMbase, KoreaMed, PubMed (MEDLINE), Embase, and CINAHL were searched for studies that examined the effects of advance care planning interventions. The inclusion criteria were original studies in English or Korean; adults ≥18 years of age (population); advance care planning (intervention); completion of advance directives (AD) or advance care planning (ACP) (outcomes); and randomized or non-randomized controlled trials (RCTs and non-RCTs, respectively) (design). Study quality was measured using the checklists of the Joanna Briggs Institute. Meta-analyses were conducted with the Comprehensive Meta-Analysis program. Results: Nine RCTs and nine non-RCTs were selected for the final analysis. The effect sizes (ES) of the outcome variables in nine RCTs were meta-analyzed, and found to range from 0.142 to 0.496 for the completion of AD and ACP (ES=0.496, 95% CI: 0.157~0.836), discussion of end-of-life care (ES=0.429, 95% CI: -0.027~0.885), quality of communication (ES=0.413, 95% CI: 0.008~0.818), decisional conflict (ES=0.349, 95% CI: -0.059~0.758), and congruence between preferences for care and delivered care (ES=0.142, 95% CI: -0.267~0.552). Conclusion ACP interventions had a positive effect on the completion of AD and ACP. To apply AD or ACP in Korea, it is necessary to develop ACP interventions that reflect aspects of Korean culture.

Purpose: The purpose of this study was to elucidate the relationship between readiness to quit smoking and smoking cessation, and identify factors associated with smoking cessation in smokers with ischemic heart disease post-coronary angiography (CAG). Methods: This descriptive study was conducted between December 1, 2020 and May 14, 2021 at a P hospital, Busan. A total of 164 subjects completed the questionnaire including general characteristics, coronary artery disease characteristics, readiness to quit smoking, and smoking cession behavior during hospitalization and 4 weeks after discharge. Results: The success rate of smoking cessation after coronary angiography in patients with ischemic heart disease was 49.4% (n = 81). In addition, 48.2% of smokers (n = 83) attempted smoking cessation after CAG, while 39.8% showed changes in smoking behavior. The readiness to quit smoking was significantly associated with smoking cessation (OR = 2.23, p < .005). Conclusion Readiness to quit smoking was identified as an important factor associated with smoking cessation in patients with cardiovascular disease in this study. In order to increase the smoking cessation rate, it is necessary to strengthen the readiness to quit smoking, followed by a tailored program for smoking cessation in patients with ischemic heart disease.

Purpose: This study aimed to investigate advance care planning needs expressed online. Methods: This study collected data from online community posts and healthcare news sites.The search keywords included “death,” “euthanasia,” “life-sustaining medical care,” “lifesustaining treatment,” “advance directives,” “advance medical directives,” and “advance care planning.” Data collection spanned from February 2018 to February 14, 2020. Out of 2,288 posts, 1,190 were included in the final analysis. Data analysis was conducted using NVivo 12, a qualitative data analysis software program. Results: Content analysis categorized patients' advance care planning needs into eight themes, 11 theme clusters, and 33 meaningful statements. Similarly, care providers' advance care planning needs were categorized into eight themes, 14 theme clusters, and 42 meaningful statements. The identified themes of care needs included life-sustaining medical care, decision-making related to life-sustaining medical care, physical care, environmental care, supportive and spiritual care, respect, preparing for death, and family. Conclusion This study identified care needs from the perspectives of patients and their families. The findings may serve as preliminary data for future research and clinical applications.

Purpose: This study aimed to investigate advance care planning needs expressed online. Methods: This study collected data from online community posts and healthcare news sites.The search keywords included “death,” “euthanasia,” “life-sustaining medical care,” “lifesustaining treatment,” “advance directives,” “advance medical directives,” and “advance care planning.” Data collection spanned from February 2018 to February 14, 2020. Out of 2,288 posts, 1,190 were included in the final analysis. Data analysis was conducted using NVivo 12, a qualitative data analysis software program. Results: Content analysis categorized patients' advance care planning needs into eight themes, 11 theme clusters, and 33 meaningful statements. Similarly, care providers' advance care planning needs were categorized into eight themes, 14 theme clusters, and 42 meaningful statements. The identified themes of care needs included life-sustaining medical care, decision-making related to life-sustaining medical care, physical care, environmental care, supportive and spiritual care, respect, preparing for death, and family. Conclusion This study identified care needs from the perspectives of patients and their families. The findings may serve as preliminary data for future research and clinical applications.

Purpose: This study aimed to investigate advance care planning needs expressed online. Methods: This study collected data from online community posts and healthcare news sites.The search keywords included “death,” “euthanasia,” “life-sustaining medical care,” “lifesustaining treatment,” “advance directives,” “advance medical directives,” and “advance care planning.” Data collection spanned from February 2018 to February 14, 2020. Out of 2,288 posts, 1,190 were included in the final analysis. Data analysis was conducted using NVivo 12, a qualitative data analysis software program. Results: Content analysis categorized patients' advance care planning needs into eight themes, 11 theme clusters, and 33 meaningful statements. Similarly, care providers' advance care planning needs were categorized into eight themes, 14 theme clusters, and 42 meaningful statements. The identified themes of care needs included life-sustaining medical care, decision-making related to life-sustaining medical care, physical care, environmental care, supportive and spiritual care, respect, preparing for death, and family. Conclusion This study identified care needs from the perspectives of patients and their families. The findings may serve as preliminary data for future research and clinical applications.

Purpose: This study aimed to investigate advance care planning needs expressed online. Methods: This study collected data from online community posts and healthcare news sites.The search keywords included “death,” “euthanasia,” “life-sustaining medical care,” “lifesustaining treatment,” “advance directives,” “advance medical directives,” and “advance care planning.” Data collection spanned from February 2018 to February 14, 2020. Out of 2,288 posts, 1,190 were included in the final analysis. Data analysis was conducted using NVivo 12, a qualitative data analysis software program. Results: Content analysis categorized patients' advance care planning needs into eight themes, 11 theme clusters, and 33 meaningful statements. Similarly, care providers' advance care planning needs were categorized into eight themes, 14 theme clusters, and 42 meaningful statements. The identified themes of care needs included life-sustaining medical care, decision-making related to life-sustaining medical care, physical care, environmental care, supportive and spiritual care, respect, preparing for death, and family. Conclusion This study identified care needs from the perspectives of patients and their families. The findings may serve as preliminary data for future research and clinical applications.

PURPOSE: The purpose of this study was to explore the level of occupational stress and emotional intelligence in hospice volunteers. METHODS: Participants were 158 hospice volunteers at hospitals in B city. Occupational stress, emotional intelligence, and general characteristics of hospice volunteers were measured. The data were analyzed with descriptive statistics, t-tests, ANOVA, and Pearson's correlation coefficients. RESULTS: The mean score for occupational stress was 2.16 points out of 4 and 4.65 out of 7 for emotional intelligence. The scores for occupational stress and emotional intelligence were significantly different by educational level and monthly income in hospice volunteers. Occupational stress was negatively correlated with emotional intelligence (r=-0.196, P=0.013). CONCLUSION: A continuous educational program is needed to offer volunteers with new hospice-related trends. To ensure quality care for patients and their families, it should be helpful to encourage hospice volunteers to build a social network to enhance their emotional intelligence.
Emotional Intelligence* ; Hospice Care ; Hospices* ; Humans ; Intelligence ; Stress, Psychological ; Volunteers*

PURPOSE: This study analyzed a path through which factors influencing death anxiety in the community-dwelling elderly, assuming personal organismic factors and microsystemic factors based on the ecology model purported by Belsky (1980). METHODS: This study was performed with 189 elderly people. Data were collected through a self-report questionnaire. The data were analyzed using the SPSS and AMOS programs. RESULTS: The factors influencing death anxiety in the elderly were depression, family support, social network, and familism value, and the explanatory power of these variables was 22%. Death anxiety increased with higher depression, higher familism value, larger social network, and lower family support. Spiritual well-being and elderly discrimination experience had indirect effects on death anxiety, and these effects were mediated by depression. CONCLUSION: Depression, family support, social network, and familism value were found to influence death anxiety in the elderly, and the strongest effect came from depression. To reduce death anxiety in the elderly, it is important to improve their relationship with their family and friends. Moreover, support should be provided by establishing local systems, and intervention should be provided to alleviate depression.
Aged ; Anxiety ; Depression ; Discrimination (Psychology) ; Ecology ; Friends ; Humans

PURPOSE: The aim of this study was to examine the mediating effect of self-efficacy in the relationship of physical and psychological symptoms to exercise adherence in patients with heart failure. METHODS: The participants in this study were 186 patients with heart failure in two hospitals located in Busan. The measures included questions about general and disease characteristics, physical symptoms, psychological symptoms, self-efficacy for exercise, and exercise adherence. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, simple and multiple regression using Baron and Kenny steps for mediation. RESULTS: There were significant differences in age, gender and comorbidity on exercise adherence. There were also significant correlations among physical and psychological symptoms, self-efficacy for exercise, and exercise adherence. Self-efficacy for exercise showed partial mediating effects in the relationship between physical symptoms and exercise adherence. CONCLUSION: Based on the findings of this study, the enhancement of self-efficacy for exercise may positively affect the exercise compliance of the patients with health failure, even while they are experiencing physical symptoms. Therefore, it is necessary to develop effective strategies to enhance self-efficacy for exercise.
Busan ; Comorbidity ; Compliance ; Heart Failure ; Heart ; Humans ; Negotiating

PURPOSE: The purpose of this study was to investigate gender related factors that influence regular exercise adherence in patients with coronary artery disease. METHODS: This secondary analysis study used data from the 2013~2015 Korea National Health and Nutrition Examination Survey (KNHANES). Three hundred and eighty patients over 20 years of age and having coronary artery disease were selected for this study. Measures included questions about regular exercise, general characteristics, health behaviors, and health status. Data were analyzed using descriptive analysis, Rao-Scott χ² statistic, and multiple logistic regression analysis with the SPSS 21.0 program. RESULTS: The results were as follows. Men did more regular exercise than women (58.8% vs 40.1%). The multivariate-adjusted Odds Ratios (OR) for regular exercise adherence in men were 2.93 (95% CI: 1.39~6.17) for non smokers and 3.06 (95% CI: 1.53~6.13) for men with 0 to 1 comorbidities. Women had a high odds ratios of 0.38 (95% CI: 0.18~0.82) for not using alcohol and 2.10 (95% CI: 1.03~4.29) for no back pain. CONCLUSION: To improve regular exercise adherence in patients with coronary artery disease, it is necessary to develop different approaches considering gender.
Back Pain ; Comorbidity ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Health Behavior ; Humans ; Korea* ; Logistic Models ; Male ; Nutrition Surveys* ; Odds Ratio