Rapid progress in modern medical technology has made it possible to sustain life and/or delay death using 'heroic' treatments. The availability of life-sustaining treatment brings several issues in end-of-life care such as 'dying with dignity' and an radical increase in health care costs. The use of Advance Directives(AD) have been widely heralded by health care providers, gerontologists, and advocacy groups as means of protecting patients' right to accept or refuse life-sustaining treatment in end-of-life care. The use of AD can not only improve patients' autonomy and quality of life but also bring efficiency in distributing health care resources. The proportion of older persons in Korean population has been increasing. Those 65 years of age or over were about 7 percent of the population. Death and dying is not limited to older persons, but it is more prevalent among them. In conjunction with an aging population and the increasing prevalence of death, the issues of death and dying will become crucial in near future in terms of 'dying with dignity', 'autonomy', and 'self-control'. This paper attempts to explode and establish the concept of advance directives (AD) based on literature review. Data sources are computer searches with the MEDLINE database. Due to the lack of prior study on AD for a Korean cases, studies abroad are reviewed. This paper suggests the need for future study on the possibility of the use of AD in Korea.

Issues related to the elderly have been recognized in Korea and nursing scholars have tried to study there issues. It is hard to say which the direction we, are going or have to go, since there has been little systemic effort to establish gerontological nursing field yet. Therefore, it is necessary to find out the trend and the guidelines of gerontolotical nursing studies for the future. Dissertation and published articles related to the elderly in the nursing field from 1991 to the February of 1997 were are reviewed. Total 127 studies were analysed in terms of concept, design/methodology, and results, and the nature and issues of the geronotologic nursing studies in Korea were explored. The results are as follows: 1. There was no clear chronological definition of the elderly. 2. The most popular research design was an exploratory/descriptive study. 3. The major concepts studies were physical and mental health. 4. Among those studies using instrument which were developed and modified and /or translated by researchers, the reliability and validity were rarely reported. 5. Theory based studies were rare. We suggest the following issues for future studies : 1. The chronological and other criteria related to the definition of elderly is needed. 2. Physiopsychosocial characteristics of Korean elderly and their managements in terms of intervention studies need to be conducted more synthetically. 3. Social issues from the change of types and function of family such as single elderly family need to be studied. 4. Participation in and collaborate with other disciplines are needed. 5 Development and test of instruments to measure phenomena or concepts is needed. 6. Macroscopic approach such as policy also needed. 7. Theory based studies are needed.

The purpose of study was to develop and validate Korean Sleep Scale A which can be easily administrated by nurse for a wide range of adult subjects. Dimensions of adult concept were derived by literature review. Previously developed sleep scales were also analyzed in order to develop scales items. The Korean sleep scale A was structured as a 15 item, 4 point like type scale. The Scale was tested an 298 female and male adult subjects after pilottest and content validation. The results showed reliability by internal consistency of Cronbach's alpha=75 Construct validity was tested by factor analysis and known group technique. Factor analysis showed 4 factor-sleep pattern, sleep evaluation, sleep result, and cause of sleep disturbance. Theses four factors explained 55.9% of total variance. Correlations between factors ranged from .15-.32. There was correlation among Korean Sleep Scale A score, Verran and Snyder-Halpern(VSH) Sleep Scale scale, and sleep satisfaction scale score, r= .71(p=.00), r=.51(p=.03), respectively. These study results partially support reliability, construct validity, and criterion related validity of Korean Sleep Scale A. Further validation study is required with other subjects and other settings.