The purpose of the study is to provide basic data to set system of Advance Directives, which contain opinions about appointing legal representative and medical choices, by checking opinions of cancer patients, the families, doctors who diagnosed or treated lung cancer patients, and nurses who have took care of ling cancer patients. The subjects of the data are 30 patients, 30 family members, 30 doctors who diagnosed or treated lung cancer patients, and 34 nurses who have taken care of lung cancer patients and the data was collected between May 1, 2009 and Oct. 29, 2009.
The study used systemized questionnaire in order to fit to the study by editing 'Advance Directives' of the University of Texas, MD Anderson Cancer center and Deok-Seung Son's tool (2008), which edited and revised pre-instruction for medical treatment of Seoul University to fit for cancer patients in a hospice ward.
The study was analyzed with SPSS Win 15.0 program to figure out general characteristic in real numbers and percentile and used x²-test to certify the difference.
1) There was a significant difference (x²=16.17, p=. 001) on the question about whether the person have heard of the appointment of legal representative for medical treatment right since 20 patients (66.7%) and family members (60.0%) said 'No' and 16 doctors (53.3%) and 27 nurses (79.4%) said 'Yes'.
For the major reason to approve the appointment of legal representative for medical treatment right was that 'families or relatives already know the decision'; 20 patients (83.3%), 17 families (60.7%), 22 doctors (88%) and 27 nurses (93.1%). There was a significant difference (x²=29.100, p=. 001) among the groups since 10 family members (35. 7%) answered 'Opinions of my family and other relatives are more important than mine.'
2) There was a significant difference (x²=28.775, p=.004) among groups in the question about who should be the subject in making decision when preparing pre-instruction for medical treatment since 11 patients (42.3%), 10 family members (38.5%), 19 doctors (70.4%), and 17 nurses (60.7%) answered as the spouse and 10 patients (38.5%) and 7 family members (26.9%) answered as a son.
3) All four groups wish the patient get comfortable and painless care (30 patients, 100%; 30 family members, 100%; 30 doctors, 100%; and 34 nurses, 100%). There was a significant difference (x²=10.187, p=.017) between the groups in the question that asked whether they wish to prolong the life of patient in the hospital when the patient fell in a coma, since 29 patients (96.7%), 20 family members (66.6%), 22 doctors (73.3%), and 29 nurses (85.3%) answered 'No' while 10 family members (33.3%) and 8 doctors (20.7%) answered 'Yes'.
There was a significant difference (x²=19.285, p=.000) among the groups on the question whether they want the patients to receive the oxygen treatment, 17 patients (56.7%), 25 family members (83.3%), 28 doctors (93.3%), and 32 nurses (94.1%) answered 'Yes', while 13 patients (43.3%) answered 'No'.
There was a significant difference(x²=14.441, p=.002) in the question if parents wanted 'the central vein catheter insertion' since 17 families (56.7%), 25 family members (83.3%), and 28 nurses (82.4%) answered 'Yes' while 16 patients (53.3%) answered 'No'.
There was a significant difference(x²=23.476, p=.002) on providing artificial nutrients through patients' 'enteral tube' since 16 family members (53.3%), 27 doctors (90.0%), 29 nurses (85.3%) were positive about it while 18 patients (60.0%) opposed it. There was also a significant difference on the question about whether they want the patients to get 'indwelling catherization' since 18 family members (60.0%), 27 doctors (90.0%), 29 nurses (85.3%) answered 'Yes' while 18 patients (60.0%) answered 'No'.
On the question that asked if they want patients' usage of antibiotic, 20 families (66.7%), 28 doctors (93.3%), 29 nurses (85.3%) answered 'Yes' while 15 patients (50.0%) said 'Yes' and 15 patients (50.0%) said 'No'.
4) Three groups wish the patient to get comfortable and painless care (30 family members, 100%; 30 doctors, 100%; and 34 nurses, 100%). There was a significant difference. On a question about if they want cardiopulmonary resuscitation, there was a significant difference (x2=10.271, p= .006) since 23 family members (76.7%), 30 doctors (100%), 32 nurses (94.1%) answered 'No' while 7 family members (23.3%) answered 'Yes'.
On the question about if they want to receive a respiratory system incision tube maintain, there was a significant difference (x²=6.203, p=.045) since 22 family members (73.7%), 29 doctors (96.7%), and 28 nurses (82.4%) disapproved it while 8 family members (26.7%) and 6 nurses (17.6%) approved it.
In conclusion, all patients, families, doctors, nurses wish to receive comfortable and painless care. Therefore, the pre-instruction of medical decision system that can be recognized both socially and legally in order to make the patients to be the subject of the decision through the preparation of medical instruction on their own not forced by doctors or families.