Purpose
It is necessary for nurses who perform tasks related to life-sustaining treatment to play a supporting role in the decision-making process of life-sustaining treatment for patients and guardians based on their knowledge of decisions and implementation, such as cessation of life-sustaining treatment. Therefore, the Knowledge Scale of the Life-Sustaining Treatment (KS-LST) was developed and reliability and validity were verified.
Methods
Our methodological study aimed at developing tools to measure the knowledge of nurses´ life-saving medical decision system and to verify their reliability and validity. To this end, preliminary questions were constructed through literature review. In this regard, content validity, face validity, k-group comparison, and composition validity through item analysis were verified, and reliability was derived from KR-20.
Results
A total of 26 questions were derived from the 35 preliminary questions through content validity and facial validity; depending on whether they were educated or not, there was a significant difference between the two groups (p=.004). The final 23 questions were derived by deleting 3 questions with low discrimination, and KR-20 was .62.
Conclusion
Using the KS-LST that was developed through this study, we can measure the nurses´ knowledge of the life-sustaining medical decision system and provide education in the deficient areas. We expect nurses with accurate knowledge to provide accurate information to patients and caregivers to help patients make the right choices.

Citations

• Knowledge, Attitudes and Nursing Stress Related to Life-Sustaining Treatment among Oncology Nurses
  Seul Lee, Suyoun Hong, Sojung Park, Soojung Lim
  The Journal of Hospice and Palliative Care.2023; 26(3): 112.     CrossRef

PURPOSE
As advanced medical care has resulted in the unintended consequence of prolonging deaths, there is a growing interest in the decision to withhold life-sustaining treatments. The purpose of this study was to determine factors associated with the decision to withhold life-sustaining treatments in middle-aged and older adults who die in hospital in the United States.
METHODS
This cross-sectional correlational study conducted secondary analysis of 2000–2012 exit interview data from the Health and Retirement Study. Adults aged 50 and older who died in hospital and who had made a decision regarding life-sustaining treatments were included. Multivariable logistic regression was used to identify factors related to the decision to withhold life-sustaining treatments.
RESULTS
Among 1,412 adults, the prevalence of the decision to withhold life-sustaining treatments was 61.1%. Significant factors associated with the decision to withhold life-sustaining treatments were being African American (Adjusted Odds Ratio [AOR]=0.50, 95% Confidential Interval [CI]=0.30~0.86), Catholic (AOR=0.5, 95% CI=0.32~0.93), having at least one private insurance policy (AOR=1.40, 95% CI=1.02~1.92), having a living will (AOR=1.71, 95% CI=1.04~2.83), and having discussed end-of-life care with someone (AOR=1.810, 95% CI=1.25~2.62).
CONCLUSION
Differences in race and religious affiliation should be considered when older adults, family members, and health care providers make decisions regarding life-sustaining treatments at the end-of-life. Also, health insurance coverage for advance care planning makes it easier for people to discuss life-sustaining treatments with health care providers.

PURPOSE
The aims of the study were to investigate relationships among intensive care unit (ICU) nurses' attitude, role perception, and nursing stress related to life sustaining treatment (LST), and secondly, to identify factors influencing nursing stress about LST.
METHODS
Participants were 202 conveniently sampled ICU nurses from general hospitals in Korea with over 300 beds. From December 1, 2015 to January 31, 2016, data were collected using structured questionnaires. The questionnaire was designed to measure nursing stress related to LST. Content validity and reliability was established for the instrument.
RESULTS
Relationships were found between attitude and role perception, and between role perception and nursing stress about LST. Participants' role perception, gender, education level, and the experience of dealing with family members of patients receiving LST accounted for 13% of variance in nursing stress about LST.
CONCLUSION
Results confirmed that ICU nurses' role perception affects nursing stress about LST. Accordingly, the nursing education programs related to LST should aim to enhance role perception of nurses, and strategies to reduce the nursing stress about LST of the nurses in ICU need to be further developed.

Citations

• Unveiling nurses’ end-of-life care experiences: Moral distress and impacts
  Myung Nam Lee, So-Hi Kwon, SuJeong Yu, Sook Hyun Park, Sinyoung Kwon, Cho Hee Kim, Myung-Hee Park, Sung Eun Choi, Sanghee Kim, Sujeong Kim
  Nursing Ethics.2024; 31(8): 1600.     CrossRef
• Factors Influencing Performance of End-of-Life Care by ICU Nurses: A Descriptive Survey Study
  Gyo Seon Lim, Yang Gyeong Yoo
  Korean Journal of Adult Nursing.2023; 35(1): 47.     CrossRef
• Knowledge, Attitudes and Nursing Stress Related to Life-Sustaining Treatment among Oncology Nurses
  Seul Lee, Suyoun Hong, Sojung Park, Soojung Lim
  The Journal of Hospice and Palliative Care.2023; 26(3): 112.     CrossRef
• Comparing Perceptions, Determinants, and Needs of Patients, Family Members, Nurses, and Physicians When Making Life-Sustaining Treatment Decisions for Patients with Hematologic Malignancies
  Semi Kim, Eun Hye Ham, Dong Yeon Kim, Seung Nam Jang, Min kyeong Kim, Hyun Ah Choi, Yun A Cho, Seung A Lee, R.N. Min Jeong Yun
  The Korean Journal of Hospice and Palliative Care.2022; 25(1): 12.     CrossRef
• Factors Affecting Psychological Burnout in Nurses Caring for Terminal Cancer Patients
  Na-Ri Seo, Hyun-E Yeom
  The Korean Journal of Hospice and Palliative Care.2022; 25(4): 159.     CrossRef
• Mediating Effects of Role Perception of Life-sustaining Treatment in the Relationship between Knowledge of Lifesustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment among Nursing College Students
  Youngmi Park, Keumhee Nam, Joohee Bae
  The Korean Journal of Hospice and Palliative Care.2021; 24(1): 36.     CrossRef
• Evaluation of the Effect of Intensive Nursing Intervention Based on Process Analysis
  Zhiying Zhang, Huiju Zhu, Osamah Ibrahim Khalaf
  Computational and Mathematical Methods in Medicine.2021; 2021: 1.     CrossRef
• Analysis of Risk Factors of Hospital Emergency Nursing Based on Comprehensive Nursing Methods
  Fujuan Chen, Xueying Xiao, Youshan Ni, Yanan Zhu, Xiao Li, Osamah Ibrahim Khalaf
  Computational and Mathematical Methods in Medicine.2021; 2021: 1.     CrossRef
• Attitudes of the General Public towards Death with Dignity and Their Determinants
  Jung-Whan Lee
  Journal of Health Informatics and Statistics.2021; 46(2): 230.     CrossRef
• Attitudes, Perceptions, and Experiences toward End-of-Life Care Decision-Making among Intensive Care Unit Nurses in Korea : An Integrative Review
  JiYeon Choi, Youn-Jung Son, Kyounghoon Lee
  Journal of Korean Critical Care Nursing.2020; 13(1): 27.     CrossRef
• The Effects of Nurses’ Knowledge of Withdrawal of Life- Sustaining Treatment, Death Anxiety, Perceptions of Hospice on Their Attitudes toward Withdrawal of Life-Sustaining Treatment
  Young Eun Lee, Yu Jin Jung, Yoo Na Jang, Hyo Eun Jeong
  The Korean Journal of Hospice and Palliative Care.2020; 23(3): 114.     CrossRef
• The influence of Moral Sensitivity, Knowledge of Advanced Directives, Good Death Perception on Nurses’ Attitudes toward the Withdrawal of Life-Sustaining Treatment in a General Hospital
  Sun Yeob Choi, Kon Hee Kim
  The Korean Journal of Rehabilitation Nursing.2020; 23(2): 120.     CrossRef
• Reliability and Validity of an Instrument Assessing Advance Directives for Nurse
  Hojung Cheon, Eunha Kim
  The Korean Journal of Hospice and Palliative Care.2019; 22(3): 134.     CrossRef
• Text Network Analysis of Newspaper Articles on Life-sustaining Treatments
  Eun-Jun Park, Dae Woong Ahn, Chan Sook Park
  Journal of Korean Academy of Community Health Nursing.2018; 29(2): 244.     CrossRef