Supportive Care in Cancer

, Volume 21, Issue 5, pp 1437–1444 | Cite as

The attitudes of Korean cancer patients, family caregivers, oncologists, and members of the general public toward advance directives

  • Bhumsuk Keam
  • Young Ho YunEmail author
  • Dae Seog HeoEmail author
  • Byeong Woo Park
  • Chi-Heum Cho
  • Sung Kim
  • Dae Ho Lee
  • Soon Nam Lee
  • Eun Sook Lee
  • Jung Hun Kang
  • Si-Young Kim
  • Jung Lim Lee
  • Chang Geol Lee
  • Yeun Keun Lim
  • Sam Yong Kim
  • Jong Soo Choi
  • Hyun Sik Jeong
  • Mison Chun
Original Article



The purpose of this study was to investigate Korean attitudes toward advance directives (ADs) among cancer patients, family caregivers, oncologists, and the general public.


A multicenter survey study explored the attitudes of participants to ADs, and hospice–palliative care (HPC) was conducted. A total of 1,242 cancer patients, 1,289 family caregivers, 303 oncologists, and 1,006 members of the general public participated in the survey.


The majority of patients, family caregivers, oncologists, and general public agreed with the necessity of ADs. However, oncologists regard “when became terminal status” as an optimal timing for completion of ADs (52.2 %), while other groups regard earlier periods as it. More than 95 % oncologist answered that cardiopulmonary resuscitation and mechanical ventilator are necessity items for ADs form, while around 70 % of other groups answered so. Multivariate analysis revealed that several factors including agreement with terminal disclosures and a positive attitude toward HPC were independently associated with necessity of ADs.


We found that attitudes toward ADs among cancer patients, family caregivers, oncologists, and the general public were significantly different. Our study also suggests that favorable attitudes toward comfort end-of-life care and HPC are keys that influence the perceived need for ADs.


Advance directives Attitude Hospice–palliative care 



This work was supported by the 2008 Korean National Cancer Control Program by the Ministry for Health, Welfare and Family Affairs, Korea, and partially by grant no. 0710730-3 from the National Cancer Center, Korea.

Conflict of interest

The authors have no competing interests to declare.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Bhumsuk Keam
    • 1
  • Young Ho Yun
    • 2
    Email author
  • Dae Seog Heo
    • 1
    Email author
  • Byeong Woo Park
    • 3
  • Chi-Heum Cho
    • 4
  • Sung Kim
    • 5
  • Dae Ho Lee
    • 6
  • Soon Nam Lee
    • 7
  • Eun Sook Lee
    • 8
  • Jung Hun Kang
    • 9
  • Si-Young Kim
    • 10
  • Jung Lim Lee
    • 11
  • Chang Geol Lee
    • 12
  • Yeun Keun Lim
    • 13
  • Sam Yong Kim
    • 14
  • Jong Soo Choi
    • 15
  • Hyun Sik Jeong
    • 16
  • Mison Chun
    • 17
  1. 1.Department of Internal Medicine and Cancer Research InstituteSeoul National University HospitalSeoulRepublic of Korea
  2. 2.Seoul National University College of MedicineSeoulRepublic of Korea
  3. 3.Department of Surgery, Yonsei University Medical CenterYonsei University College of MedicineSeoulSouth Korea
  4. 4.Department of Obstetrics and Gynecology, School of MedicineKeimyung UniversityDaeguSouth Korea
  5. 5.Department of Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  6. 6.Department of Internal Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
  7. 7.Department of Internal MedicineEwha Womans University School of MedicineSeoulSouth Korea
  8. 8.Division of Convergence Technology, Center for Breast Cancer, Research Institute and HospitalNational Cancer CenterGoyangSouth Korea
  9. 9.Departments of Internal Medicine, Post-Graduate Medical SchoolGyeongsang National UniversityJinjuSouth Korea
  10. 10.Department of Medical Oncology/HematologyKyung Hee University HospitalSeoulSouth Korea
  11. 11.Department of HematooncologyFatima HospitalDaeguSouth Korea
  12. 12.Department of Radiation Oncology, Yonsei Cancer CenterYonsei University College of MedicineSeoulSouth Korea
  13. 13.Department of Internal MedicineKwangju Christian HospitalKwangjuSouth Korea
  14. 14.Department of Internal MedicineChungnam National University College of MedicineDaejeonSouth Korea
  15. 15.Department of Hematooncology, Gangneung Asan HospitalAsan University School of MedicineGangneungSouth Korea
  16. 16.Departments of Internal MedicinePohang Sunlin HospitalPohangSouth Korea
  17. 17.Department of Radiation OncologyAjou University School of MedicineSuwonSouth Korea

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