2015, Vol.18, No.2

Korean Journal of Medical Ethics 2023 KCI Impact Factor : 1.21

pISSN : 2005-8284 / eISSN : 2234-3598
https://journal.kci.go.kr/medethics

The purpose of this study was to identify the factors affecting the performance of clinical nurses in terminal care settings. The participants in this study were 150 nurses working in hospitals in and around the South Korean city of Daegu. Data were collected April 2015 by using self-report questionnaires and analyzed with the IBM SPSS WIN 19.0 program. Significant relations were found among humanistic knowledge (r=0.377, p<0.01), hospice perception (r=0.290, p<0.01), spirituality (r=0.481, p<0.01), and terminal care performance. The significant predictors of the terminal care performance of the hospital nurses were clinical working area, spirituality, and humanistic knowledge. These variables explained 32% of the variance in the terminal care performance of the hospital nurses. These results of this study suggest that the performance of hospital nurses in terminal care settings can be improved by enhancing their spirituality and humanistic knowledge.

This cross-sectional study is designed to evaluate the recognition, subjective understanding (SU), and objective understanding (OU) of the terms used in obtaining informed consent for surgery and also the levels satisfaction with the explanations (ES) provided in the informed consent process. Data are collected using a structured self-report questionnaire answered by 243 patients who had orthopedic operations in South Korea in July to August, 2014. The mean number of terms recognized is 6.24, and lower in age over 50 years (F=11.46, p<0.001) and education level of elementary and middle school compared with college and higher (F=12.06, p<0.001). The mean SU was 73.90 out of 100 points and was lower in patients without a high school education than in those with a college education (F=12.39, p<0.001). The mean OU is 68.04 out of 100 points and lower in age over 50 years (F=5.91, p<0.001) and education level of elementary and middle school compared with college and higher (F=8.06, p=0.001). ES is positively correlated with both term recognition (r=0.168, p=0.009) and SU (r=0.135, p=0.035). The results of this study suggest that medical personnel should monitor patients’ recognition, understanding, and explanation satisfaction of the terms used in the consent process and give feedback to patients to enhance their understanding and explanation satisfaction.

According to the international norms, the researcher who wants to conduct the clinical trial must obtain the informed consent from the research participant in order to protect their rights and welfare and to respect their autonomy. To obtain the informed consent appropriately, the researcher must provide the sufficient information and the detailed explanations about the research and allow adequate opportunity to ask questions before obtaining the informed consent. In Korea, these requirements are specified as the researcher’s legal liabilities both in the Pharmaceutical Affairs Act and in the Korean Good Clinical Practice. Recently, there has been a growing interest in the use of the electronic media and process for obtaining the informed consent since the electronic informed consent is convenient for delivering and storing the information. However, it is questionable whether the use of the electronic media and process for obtaining informed consent satisfies the legal and ethical requirements laid out in the domestic law and the international norms because these principles and standards within them are created on the premise that the informed consent could be obtained on paper. So, in this article, I identify the ethical issues surrounding the electronic informed consent that require the attention not only of the researcher but also of the Institutional Review Board. In particular, I analyze and comment on the guidance concerning the electronic informed consent prepared by the U.S. Department of Health and Human Services and the U.S. Food and Drug Administration.