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Original Articles
The Notion of Death and Caring Behaviors in one Community
Sung Hee Ko, Young Hee Lee
Journal of Korean Academy of Nursing 1999;29(3):688-699.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.3.688
AbstractAbstract PDF

This study was to find out the perception of toward death and caring behavior of lay parsons in one community : One Island in Pusan County, Chonbuk. The methodology of this study was ethnography. For this study, The fieldwork was conducted from October 1997 to July 1998. Data collected by in-depth interview and participant observations. The participants consisted of were 17 persons of both sexes. The key informants were four specific people. The result of this study is as follows; The people perceived two different kinds of death. Normal death, which means death from old age. The person was respected as an ancestor God and was believed to exist forever with their offspring. Abnormal death was regarded as negative, many had fears toward this king of death. The causes of abnormal death were supernatural phenomena and had absolute holy meanings. Whether death was good or bad, The death was not personal, but collective events as family or community affairs and was interpreted as death and birth for their offsprings. Funeral rites were family-centered and/or community-centered. The did normal procedures for normal deaths for abnormal deaths, there were many protective ceremonies(BuJungmagi : the prevention of the taboo of uncleanliness) for the remaining people. These ceremonies combined confucism and shamanism. Caring behavior for dying persons was ruled as community-centered, reciprocal and reality-centered principles.

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Development of an Education Program for Hospice Care and Its Performance
Boon Han Kim, Moon Sil Kim, Hung Kyu Kim, Tae Joon Jeong, Young Ran Tak, Hye Ryoung Kim, Mi Young Chon
Journal of Korean Academy of Nursing 1999;29(3):576-584.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.3.576
AbstractAbstract PDF

The purpose of this study was to develop an education program for hospice care and to examine the effect of program. The education program for hospice care was developed based on the philosophy and principle of Hospice and integrated with various professional areas related to the problems with witch terminal patients and their family might be associated. The program was continued for 16 weeks and consisted of lectures and practices. The courses of this program were The Concept and Principle of Hospice, The Role of the Hospice Nurse, The Characteristics of Terminal Disease, Physical Care in Terminal Patients, Death Orientation, Psychological care for Terminal Patients, Spiritual care for Terminal Patients, and Care for the Family. To identify the effect of the education program for hospice care, the difference in death orientation of subjects between the pre and post performance of the education program was examined using the t-test. The finding of this statistic indicated that this education program for hospice care was effective in terms of changing the death orientation of subjects with positive direction. The education program for hospice care was performed several times at Kwangrim Hospice Missionary, Chungbuk University Hospital, and Wooam Church. Case studies were reported for a description after the performance of education. put this at the beginning 8 the sentence. In conclusion, the education program for hospice care was developed effectively. Therefore, this program should be used to educate and activate the subjects in community to be participants in hospice care.

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How People Understand Death: a Coorientational Look
Eun Ja Yeun, Hung Kyu Kim
Journal of Korean Academy of Nursing 1998;28(2):270-279.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.2.270
AbstractAbstract PDF

Since death is an extremely subjective and unique experience, if we take into account the lack of understanding about death due to the difficulty in methodology, it is very important to try to understand the subjectivity of death. In this respect, Q-methodology that explains and shows the respondents' subjectivity by objectifying his subjectivity is employed as a solution to the questions in this study. Therefore, the purpose of this study was to provide data on how medical personnel should treat their patients, when, it comes to death ; by finding out the opinions of those who are being treated, namely the patients, and those who are providing the treatment, namely the medical personnel. It also by examined the characteristics and relationships between these two groups on attitudes to death. The results of this study show that medical personnel have two(fate-recipient, reality-oriented) types of response and patients have three(religion-dependent, science-adherent, sardonist) types. Medical personnel saw patients as having three(life-attached, traditionalist, death-rejector) types of response and to patients saw medical personnel as having two(rationalist, humanist)types. The relationship between the above-mentioned types will be examined in a coorientation model, the subjectivity of the medical personnel and the patient toward death indicates a relatively high understanding between the two groups under the great proposition of 'death'. Therefore, in their relationship with people who are facing death, the provider of care, namely the medical personnel, should identify the subjectivity of the patient before approaching them. By doing this, they can minimize the conflicts they might experience in establishing a therapeutic relationship, reduce suffering, and help the patient in greeting a more comfortable death. Throughout the study, Q-methodology expands out understanding of coorientation model that has only been approached with R-methodology. This study confirmed Q's potentiality and its validity in human subjective matters.

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Development and Application of Online Education on Death
Kae Hwa Jo, Hyun Ji Lee, Yun Ju Lee
Journal of Korean Academy of Nursing 2007;37(4):442-452.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.4.442
AbstractAbstract PDF
Purpose

The purpose of this study was to develop an online education on death, ‘successful life, and beautiful death’ for university students and to evaluate students' changes regarding perception of self and death.

Method

A quasi-experimental design was used with one experimental group pre-post test. Subjects were 154 students who enrolled for online education about death for 16 weeks. SPSS/WIN 12 was used for analyzing data.

Result

The results of the study clearly indicated this class had positive effects on students' perception of death-related concepts, attitudes toward death, and self-concept, showing statistically significant higher scores in post-tests than in pre-tests. In addition, the result of class evaluations showed a positive response,

Conclusion

Findings suggested that this online education about death was effective to change students' perceptions of death related knowledge, attitude toward death, and self-concept. Recommendations for further studies were provided.

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Types of Students' Death Attitudes Majoring in Human Service Area: Q-Methodological Approach
Kae Hwa Jo, Hyun Ji Lee, Yun Ju Lee
Journal of Korean Academy of Nursing 2005;35(5):829-841.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.5.829
AbstractAbstract PDF
Purpose

The purpose of this study was to analyze death attitudes of students majoring in the human service area, such as nursing science, education, and social welfare.

Method

The Q-methodology which provides a method of analyzing the subjectivity of each item was used. The 38 selected Q-statements from each of 42 subjects were classified into a shape of normal distribution using a 9 point scale. The collected data was analyzed using a QUANL PC program.

Result

Four types of death attitudes for research subjects in nursing, education, and social welfare areas were identified. Type I is fatalistic admission, Type II is pursuit of existential life, Type III is uncertainty of life after death, and Type IV is separation-connection between life and death.

Conclusion

The results of the study indicate that different approaches of death educational programs are recommended based on the four types of death attitudes.

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Development and Evaluation of a Self-Reflection Program for Intensive Care Unit Nurses Who Have Experienced the Death of Pediatric Patients
Hyun-Ju Kang, Kyung-Sook Bang
J Korean Acad Nurs 2017;47(3):392-405.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.392
AbstractAbstract PDF
Abstract Purpose

This study aims to develop a self-reflection program for nurses who have experienced the death of pediatric patients in the intensive care unit and to evaluate its effectiveness.

Methods

The self-reflection program was developed by means of the following four steps: establishment of the goal through investigation of an initial request, drawing up the program, preliminary research, and implementation and improvement of the program. The study employed a methodological triangulation to evaluate the effectiveness of the program. Participants were 38 nurses who had experienced the death of pediatric patients (experimental group=15, control group=23); they were recruited using convenience sampling. The self-reflection program was provided over 6 weeks (6 sessions). Data were collected from April to August, 2014 and analyzed using t-tests and content analysis.

Results

The quantitative results showed that changes in personal growth (t=-6.33, p<.001) and burnout scores (z=-2.76, p=.005) were better in the experimental group compared to the control group. The qualitative results exhibited two themes, namely “personal growth” and “professional growth”, and ten sub-themes.

Conclusion

The self-reflection program developed by this study was effective in helping nurses who had experienced the death of pediatric patients to achieve personal growth through self-reflection, and it was confirmed that the program can be applied in a realistic clinical nursing setting. Furthermore, it can be recommended as an intervention program for clinical nurses.

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Nurses' Experiences of the Death of Patients in Geriatric Hospitals
Mi Joung Yi, Jeong Seop Lee
J Korean Acad Nurs 2015;45(4):513-522.   Published online August 31, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.4.513
AbstractAbstract PDF
Purpose

The purpose of this study was to identify and understand nurses' experiences of the death of patients in geriatric hospitals.

Methods

Van Manen's hermeneutic phenomenological analysis was applied in the interpretation of experiential descriptions of seven nurses who had experienced the death of patients in a geriatric hospital.

Results

The essential subjects derived from the experience of the nurses on the death of patients in a geriatric hospital are covered in the following 7 themes. 'Placed in death site', 'Difficult repetition of death and farewell', 'Emotional waves that rushes in after farewell', 'Dilemmas in a place with no preparation to greet expected death', 'Getting dull from continually being struck with sorrow', 'Being together with living death', and 'Showing courtesy for a good farewell and living well'.

Conclusion

The results of this research will contribute to the development of policy on all the deaths of patients in geriatric hospitals and suggest basic data that need to be applied in real practice and directions to introduce plans for realistic improvements in nursing care of deathbed patients in geriatric hospitals.

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Effects of Death Anxiety and Meaning of Life on Somatization of Grandparent Raising Grandchildren
Se-Young Kim
J Korean Acad Nurs 2015;45(2):262-270.   Published online April 30, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.2.262
AbstractAbstract PDF
Purpose

This study was conducted in order to examine the effects of death anxiety and meaning of life on somatization of grandparents raising grandchildren.

Methods

A convenience sample of 92 elderly grandparents raising grandchildren was recruited. The study instrument for death anxiety was the 5-point 15 items scale designed by Templer and translated by Ko, Choi, & Lee and for meaning of life, the 7-point 10-items scale by Steger, Frazier, Oishi & Kaler and translated by Won, Kim & Kwon. For somatization, the 5-point 12 items scale designed by Derogatis and translated by Kim, Kim & Won was used. Collected data were analyzed with descriptive statistics, independent t-test, one-way ANOVA, Pearson Correlation and regression using the SPSS 21.0 program.

Results

Average scores were 3.55 for death anxiety, 3.43 for meaning of life, and 2.74 for somatization. Death anxiety had the highest positive correlation with somatization. Meaning of life was negatively correlated with death anxiety and somatization. Death anxiety and health status were shown to influence somatization but meaning of life was not shown to influence somatization.

Conclusion

The research results indicate that death anxiety and health status influence somatization in grandparents raising grandchildren. These results also provide basic information on the importance of nursing interventions in which the variables influencing somatization in grandparents raising grandchildren are considered.

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Effect of Family Cohesion, Subjective Happiness and other Factors on Death Anxiety in Korean Elders
Kae Hwa Jo, Byung Sook Song
J Korean Acad Nurs 2012;42(5):680-688.   Published online October 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.5.680
AbstractAbstract PDF
Purpose

The purposes of this study were to explore the effects of family cohesion and subjective happiness on death anxiety of Korean elders and to identify other factors contributing to death anxiety.

Methods

The participants were 280 elders who lived in P metropolitan city. Data were collected between November 5, 2011 and January 12, 2012 using the Short Portable Mental Status Questionnaire (SPMSQ), Family Cohesion Evaluation Scale, Subjective Happiness Scale, and Fear of Death Scale (FODS). Data were analyzed using the SPSS/WIN 19.0 program.

Results

Family cohesion, marital status, religious activity, perceived health status, and subjective happiness were included in the factors affecting death anxiety of Korean elders. These variables explained 50.1% of death anxiety.

Conclusion

The results of the study indicate that these variables should be considered in developing nursing intervention programs to decrease death anxiety and increase family cohesion and subjective happiness for life integration in Korean elders.

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Development and Evaluation of a Dignified Dying Scale for Korean Adults
Kae-Hwa Jo
J Korean Acad Nurs 2011;41(3):313-324.   Published online June 13, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.3.313
AbstractAbstract PDF
Purpose

The study was done to develop a dignified dying scale for Korean adults.

Methods

The process included construction of a conceptual framework, generation of initial items, verification of content validity, selection of secondary items, preliminary study, and extraction of final items. The participants were 428 adults who lived in one of 3 Korean metropolitan cities: Seoul, Daegu, and Busan. Item analysis, factor analysis, criterion related validity, and internal consistency were used to analyze the data. Data collection was done from March to June 2010.

Results

Thirty items were selected for the final scale, and categorized into 5 factors explaining 54.5% of the total variance. The factors were labeled as maintaining emotional comfort (10 items), arranging social relationship (9 items), avoiding suffering (3 items), maintaining autonomous decision making (4 items), and role preservation (4 items). The scores for the scale were significantly correlated with personal meanings of death scale. Cronbach's alpha coefficient for the 30 items was .92.

Conclusion

The above findings indicate that the dignified dying scale has a good validity and reliability when used with Korean adults.

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Effects of a Death Education Program on Life Satisfaction and Attitude toward Death in College Students
Eun Hee Kim, Eunjoo Lee
J Korean Acad Nurs 2009;39(1):1-9.   Published online February 28, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.1.1
AbstractAbstract PDF
Purpose

The purpose of this experimental study was to examine the values of a death education program developed to improve life satisfaction and attitude toward death in college students.

Methods

The death education program was developed and then used with 22 college students for 5 weeks, once a week for 150 min. Before and after the intervention, students responded a questionnaire developed to measure life satisfaction and attitude toward death. t-test, χ2-test, and paired t-test with the SPSS program were used to analyze the data.

Results

The death education program significantly improved life satisfaction but had no statistically significant effect on attitude toward death. There was a significant difference in life satisfaction between the experimental and control groups but not in attitude toward death.

Conclusion

Based on the above results, it is apparent that the death education program has an affirmative effect on life satisfaction in college students and some impact on attitude toward death. We suggest, therefore, that the death education program should be used with all human beings to help them recognize the values of themselves and their current lives and improve their satisfaction with life.

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Relationship between Self-efficacy, Depression, Level of Satisfaction and Death Attitude of College Students
Kae-Hwa Jo, Hyun Ji Lee
Journal of Korean Academy of Nursing 2008;38(2):229-237.   Published online April 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.2.229
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the relationship among self-efficacy, depression, life satisfaction and death attitude of college students.

Methods

The subjects consisted of 232 college students. Data were collected by self-reported questionnaires, which were constructed to include self-efficacy, depression, satisfaction with life, and death attitude. Data were analyzed by the SPSS/PC WIN. 12.0 program.

Results

Death attitude and life satisfaction of college students were significantly different according to frequency of death ideation. Death attitude for college students correlated with self-efficacy, depression, and life atisfaction. The most significant predictor of death attitude for college students was life satisfaction.

Conclusion

The above findings indicate that death attitude for college students is influenced by self-efficacy, depression, and life satisfaction. These findings suggest that a death education program to improve life satisfaction and to give a positive attitude toward death is needed for college students.

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Development of an Evaluation Instrument for Subjects Related to Death
Kae Hwa Jo, Hyun Ji Lee, Yun Joo Lee
Journal of Korean Academy of Nursing 2006;36(1):74-83.   Published online February 28, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.1.74
AbstractAbstract PDF
Purpose

The purpose of this study was to develop an evaluation instrument integrated and interdisciplinary death education for the human service areas such as nursing, social welfare, and education and to test the reliability and validity of it.

Method

The subjects used to verify the instrument's reliability and validity were 407 students who were enrolled in the departments of nursing, social welfare, and education in universities located in Seoul, Pusan, Daegu, and Daejeon. The data was collected from April to May, 2005, and was analyzed by SPSS/WIN 12.

Result

A factor analysis was conducted. Items with over a .40 factor loading and over a 1.0 eigen value were selected. Nine identified factors were learning about death, role of professionals, personal attitudes, hospice care, ethics and legal issues, death and dying, spiritual aspect of death, transcultural aspect of death, and multidisciplinary theory of death. The instrument consisted of 44 items and the reliability was a cronbach's of .953

Conclusion

Based on the study results, the content scale developed in this study was identified as a tool with a high degree of reliability and validity.

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