Research in Community and Public Health Nursing

Original Articles

[English] The Influence of Self-Esteem and Attitudes toward Organ Donation and Euthanasia on Attitudes toward Advance Directives in Married Middle-Aged Adults: A Cross-Sectional Study: Eun-Ho Ha; Res Community Public Health Nurs. 2026;37(2):136-151. Published online June 30, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01487

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Abstract PDF: Purpose
Preparation for organ donation, euthanasia, and advance directives (AD) during midlife contributes to a dignified end-of-life experience. Self-esteem functions as a key psychological resource in this process. This study aimed to examine self-esteem (SE) and attitudes toward organ donation (ATOD), euthanasia (ATE), and advance directives (ATAD), and to assess their effects on ATAD among married middle-aged adults. Methods: A total of 154 middle-aged adults residing in six community regions across Korea participated in the study. Data were analyzed using SPSS version 23.0, employing descriptive statistics, correlation analysis, and hierarchical regression. Results: SE was positively correlated with ATOD (r=.386, p<.001), ATE (r=.170, p=.035), and ATAD (r=.462, p<.001). ATE was positively correlated with ATOD (r=.402, p<.001), and ATAD was positively correlated with ATOD (r=.677, p<.001) and ATE (r=.384, p<.001). Hierarchical regression analysis demonstrated that ATOD (β=.22, p=.002), being in the 40∼49 age group (β=.19, p=.006), lack of awareness of AD (β=−.18, p=.002), SE (β=.14, p=.016), lower frequency of thinking about organ donation (β=−.13, p=.035), and absence of religion (β=−.10, p=.025) were significant predictors of ATAD. These variables collectively explained 74% of the total variance in ATAD. Conclusion: The findings underscore the need to develop multidisciplinary educational strategies aimed at enhancing key factors that influence ATAD among married middle-aged adults.

[English] The Relationships between Knowledge on Advance Directive, Attitudes towards the Withdrawal of Life-sustaining Treatment and Quality of Life in Hemodialysis Patients: Sun Ae Joung, Kyung Yeon Park; J Korean Acad Community Health Nurs. 2017;28(3):291-301. Published online September 30, 2017; DOI: https://doi.org/10.12799/jkachn.2017.28.3.291

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PURPOSE
This study aims to investigate the relationships between knowledge on advance directive, attitudes towards the withdrawal of life-sustaining treatment and quality of life among hemodialysis patients.
METHODS
A descriptive correlational study was conducted with 103 hemodialysis patients. Data were collected using a structured questionnaire from May to September of 2016, and analysed by using descriptive statistics, t-test, ANOVA and Pearson correlation coefficient.
RESULTS
The participants' knowledge level on advance directive was 5.47Â±2.08 out of 9, the attitudes towards the withdrawal of life-sustaining treatment was 3.22Â±0.49 out of 5, and the quality of life was 3.35Â±0.92 out of 6. The knowledge on advance directive was positively correlated with attitudes towards the withdrawal of life-sustaining treatment (r=.21, p=.037) and quality of life (r=.21, p=.036).
CONCLUSION
According to the results of this study, the level of knowledge on advance directive is preferred to improve the quality of life of hemodialysis patients. It is needed to support and maintain ongoing education opportunities in order to improve the level of knowledge on advance directive among patients undergoing hemodialysis.

Citations

Citations to this article as recorded by

Effects of the healing beats application on anxiety, stress, and well-being in hemodialysis patients in Korea: a randomized controlled trial
Se-Na Yu, Myung-Haeng Hur
Journal of Korean Biological Nursing Science.2025; 27(1): 12. CrossRef
Factors that Influence Attitudes toward Advance Directives among Hemodialysis Patients
Minhee Cho, Hyunjoo Na
Journal of Hospice and Palliative Care.2024; 27(1): 11. CrossRef
Factors Influencing Advanced Directives Among Hemodialysis Patients
Eunseong SON, Minjeong SEO
Korean Journal of Medical Ethics.2022; 25(3): 243. CrossRef
Relationship between Ineffective Attitudes and General Health in Patients with Chronic Renal Disease Undergoing Hemodialysis in a Hospital in Gorgan, Iran
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Japanese Journal of Clinical Oncology.2020; 50(9): 976. CrossRef
Influence of Older Person's Ego Integrity and Knowledge of Advance Directives on their Attitude toward Withdrawal from Life-sustaining Treatment
Eun Yi Yeom, Kum Sook Seo
Journal of Korean Gerontological Nursing.2019; 21(3): 173. CrossRef
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-
Nam Joo Je, Jeong Seok Hwa
The Korean Journal of Hospice and Palliative Care.2018; 21(3): 92. CrossRef

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