title: Relationship of social support and decisional conflict to advance directives attitude in Korean older adults: A community-based cross-sectional study.
abstract: OBJECTIVE
  The aim of this study was to clarify the relationship between social support, decisional conflict, and attitude towards advance directives, and determine whether decisional conflict mediates the relation between social support and advance directives attitude among older adults in South Korea.
  
  
  METHODS
  In total, 209 community-based older adults (mean age, 74.82 years) participated in this cross-sectional study. Demographic characteristics, self-perceived health status, social support, decisional conflict, and advance directives attitude were investigated via a structured questionnaire. Data analysis was carried out using Pearson's correlation and path analyses.
  
  
  RESULTS
  The mean score of advance directives attitude was 48.01 (range, 35-61). Decisional conflict and social support were both significantly related to advance directives attitude (P < 0.001). Additionally, decisional conflict was a mediator between social support and advance directives attitudes.
  
  
  CONCLUSIONS
  The results confirmed the importance of social support for reducing decisional conflict and encouraging positive attitudes toward advance directives. Future studies are needed to support the development of culturally sensitive educational approaches regarding advance directives for older adults in Korea.
authors.affiliation: Nursing Policy Research Institute, College of Nursing, Yonsei University, Seoul, Korea.
authors.forename: JuHee
authors.initials: J
authors.lastname: Lee
authors.affiliation: Division of Nursing Science, Ewha Womans University, Seoul, Korea.
authors.forename: Dukyoo
authors.initials: D
authors.lastname: Jung
authors.affiliation: Nursing Policy Research Institute, College of Nursing, Yonsei University, Seoul, Korea.
authors.forename: MoonKi
authors.initials: M
authors.lastname: Choi
mesh_terms: D016223:Advance Directives; D000368:Aged; D001294:Attitude to Health; D003220:Conflict, Psychological; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D056910:Republic of Korea
keywords: advance directives; conflict; elderly; end of life care; social support