바로가기메뉴

본문 바로가기 주메뉴 바로가기

The Korean Journal of Health Psychology

The Effect of Self-Efficacy on Death Preparation Behavior in Older Adults: Mediating Effect of Family Support

The Korean Journal of Health Psychology / The Korean Journal of Health Psychology, (P)1229-070X; (E)2713-9581
2018, v.23 no.2, pp.525-545
https://doi.org/10.17315/kjhp.2018.23.2.012



Abstract

There has been growing interest in ‘well-dying’ and ‘good death’ and the need to examine factors that may affect an individual’s preparation for death has been highlighted. Based on previous studies that showed that self-efficacy and social support are associated with health-related behaviors, this study was designed to examine the relationship between self-efficacy and the behavioral indices associated with the preparation for death in older adults. This study also investigated the mediating effect of support from family, friends, and significant others on this relationship. The participants of this study were 106 older adults over the age of 70 living in the Korean metropolitan area. The results of structural equation modeling indicated that family support fully mediated the relationship between self-efficacy and death preparation behavior. Such results suggest that self-efficacy and family support in late adulthood may help older adults to actively participate in preparing for their end of life. Especially in Korea where the role of family support is emphasized in death preparation behaviors, the current study suggests the need for augmenting psychosocial factors including self-efficacy and family support in order to foster the preparation necessary for well-dying.

keywords
웰다잉, 자기효능감, 사회적 지지, 가족의 지지, 죽음준비 행동, well-dying, self-efficacy, social support, family support, preparation for death

Reference

1.

강소랑, 문상호 (2012). 가족관계 사회자본이 중·고령자 삶의 질에 미치는 영향. 한국행정학보, 46(3), 271-298.

2.

김명숙 (2012). 한국인의 행복과 좋은 죽음에 대한 표상과 인식의 특징. 인문학연구, 86, 307-352.

3.

김미순, 하춘광, 김효순 (2011). 내세관과 죽음준비도 및 생활만족도에 관한 연구. 한국가족복지학, 16(1), 111-136.

4.

김민선, 서영석 (2009). 공과대학 학생들이 지각한 맥락적 지지와 진로미결정의 관계에서 대처효능감과 결과기대의 매개효과. 한국심리학회지: 여성, 14(1), 1-22.

5.

김숙, 한정란 (2012). 성인들의 죽음에 관한 인식, 죽음준비, 죽음불안. 인구교육, 5(1), 23-48.

6.

김혜숙, 허준수 (2010). 노인의 건강증진행위 영향요인에 관한 연구: 서울지역 거주노인을 중심으로. 한국노년학, 30(4), 1129-1143.

7.

나기석 (1997). 빈곤 노인의 사회적지지 체계에 관한 연구: 강서구 영구임대 아파트 거주 생활보호 대상노인을 중심으로. 강남대학교 석사학위 청구논문.

8.

문남숙, 남기민 (2008). 노인의 죽음준비도와 성공적 노화의 관계-우울 및 죽음불안의 매개효과를 중심으로. 한국노년학, 28(4), 1227-1248.

9.

박대수 (2014). 한국(韓國)의 문화(文化): 한국인의 수목장 선호도와 효율적 활용방안 연구. 한국사상과 문화, 75, 427-456.

10.

박현식 (2012). 베이비부머의 노후준비와 성공적 노후관계 연구. 노인복지연구, 58, 281-302.

11.

송양민, 유경 (2011). 죽음준비교육이 노인의 죽음불안과 생활만족도, 심리적 안녕감에 미치는 효과 연구. 노인복지연구, 54, 111-134.

12.

송현동 (2006). 현대 한국의 장례의식에 나타난 죽음관. 종교연구, 43, 139-166.

13.

신근영, 고재욱 (2017). 노인의 자기 효능감이 노후준비에 미치는 영향. 한국콘텐츠학회논문지, 17(9), 255-267.

14.

신노라, 안창일 (2004). 성인 애착 유형과 자기개념, 효능감, 대처 양식, 사회적지지 수준과 대인불안의 관계. 한국심리학회지: 임상, 23(4), 949-968.

15.

유민지, 이기숙 (2002). 노년기 가족관계 향상을 위한 프로그램 개발 및 평가. 한국노년학, 21(3), 91-109.

16.

오현수 (1993). 여성관절염 환자의 건강증진과 삶의 질. 대한간호학회지, 23(4), 617-630.

17.

이두찬, 제미경, 전향란 (2016). 상조서비스 이용실태와 소비자 인식. 소비자문제연구, 47(1), 67-89.

18.

이민혜, 박인환 (2015). 노인 암 환자의 사전의사결정에 대한 태도와 관련요인. 성인간호학회지, 27(4), 449-458.

19.

이이정 (2016). 죽음준비교육의 현황과 과제. 노년교육연구, 2(1), 69-88.

20.

이정인, 김순이 (2011). 노인의 죽음불안에 영향을 미치는 요인. 한국보건간호학회지, 25(1), 28-37.

21.

장인순, 김수미 (2002). 노인의 사회적 지지망과 죽음불안과의 관계. 노인간호학회지, 4(1), 107-116.

22.

정순둘, 김수현, 구미정 (2014). 죽음관련 요인과 죽음준비의 관계. 한국인구학, 37(1), 131-153.

23.

조계화, 송병숙 (2012). 가족응집력과 주관적 행복감이 한국 노인의 죽음불안에 미치는 영향요인. 대한간호학회지, 42(5), 680-688.

24.

통계청 (2016). 노인실태조사. http://kostat.go.kr에서 2018, 05, 30 인출.

25.

허진영, 임현묵 (2010). 생활체육참여자의 사회적 상호작용과 자기효능감 및 운동지속의 관계. 한국체육과학회지, 19(2), 433-443.

26.

Abu-Bader, S. H., Rogers, A., & Barusch, A. S. (2003). Predictors of life satisfaction in frail elderly. Journal of Gerontological Social Work, 38(3), 3-17.

27.

Anderson, E. S., Winett, R. A., & Wojcik, J. R. (2007). Self-regulation, self-efficacy, outcome expectations, and social support: Social cognitive theory and nutrition behavior. Annals of Behavioral Medicine, 34(3), 304-312.

28.

Barry, L. C., Kasl, S. V., & Prigerson, H. G. (2002). Psychiatric disorders among bereaved persons: The role of perceived circumstances of death and preparedness for death. The American Journal of Geriatric Psychiatry, 10(4), 447-457.

29.

Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215.

30.

Bandura, A. (1986). The explanatory and predictive scope of self-efficacy theory. Journal of Social and Clinical Psychology, 4(3), 359-373.

31.

Bauman, A. E., Reis, R. S., Sallis, J. F., Wells, J. C., Loos, R. J. F., & Martin, B. W. (2012). Correlates of physical activity: Why are some people physically active and others not? Lancet, 380(9838), 258–271.

32.

Beauchamp, T. L., & Childress, J. F. (2001). Principles of biomedical ethics. New York: Oxford University Press.

33.

Blackhall, L. J., Murphy, S. T., Frank, G., Michel, V., & Azen, S. (1995). Ethnicity and attitudes toward patient autonomy. Journal of the American Medical Association, 274(10), 820-825.

34.

Boerner, K., Carr, D., & Moorman, S. (2013). Family relationships and advance care planning: Do supportive and critical relations encourage or hinder planning?. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 68(2), 246-456.

35.

Bullock, K. (2011). The influence of culture on end-of-life decision making. Journal of Social Work in End-of-life & Palliative Care, 7(1), 83-98.

36.

Carr, D., & Khodyakov, D. (2007). End-of-life health care planning among young-old adults: An assessment of psychosocial influences. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 62(2), 135-141.

37.

Carr, D., Moorman, S. M., & Boerner, K. (2013). End-of-life planning in a family context: Does relationship quality affect whether (and with whom) older adults plan?. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 68(4), 586-592.

38.

Chan, C. K., & Yau, M. K. (2010). Death preparation among the ethnic Chinese well-elderly in Singapore: An exploratory study. OMEGA-Journal of Death and Dying, 60(3), 225-239.

39.

Cicirelli, V. G. (2003). Older adults’ fear and acceptance of death: A transition model. Ageing International, 28(1), 66-81

40.

Clark, N. M., & Dodge, J. A. (1999). Exploring self-efficacy as a predictor of disease management. Health Education & Behavior, 26(1), 72-89.

41.

Clarke, A., & Seymour, J. (2010). “At the foot of a very long ladder”: Discussing the end of life with older people and informal caregivers. Journal of Pain and Symptom Management, 40(6), 857-869.

42.

Cohen, S., & Hoberman, H. M. (1983). Positive events and social supports as buffers of life change stress. Journal of Applied Social Psychology, 13(2), 99-125.

43.

Costello, J. (2006). Dying well: Nurses’ experiences of ‘good and bad’ deaths in hospital. Journal of Advanced Nursing, 54(5), 594-601.

44.

del Pozo Puente, K., Hidalgo, J. L., Herráez, M. J. S., Bravo, B. N., Rodríguez, J. O., & Guillén, V. G. (2014). Study of the factors influencing the preparation of advance directives. Archives of Gerontology and Geriatrics, 58(1), 20-24.

45.

Detering, K. M., Hancock, A. D., Reade, M. C., & Silvester, W. (2010). The impact of advance care planning on end of life care in elderly patients: Randomised controlled trial. British Medical Journal, 340(7751), 847-847.

46.

Dishman, R. K., Motl, R. W., Sallis, J. F., Dunn, A. L., Birnbaum, A. S., Welk, G. J., ... Jobe, J. B. (2005). Self-management strategies mediate self-efficacy and physical activity. American journal of preventive medicine, 29(1), 10-18.

47.

Dobbs, D., Park, N. S., Jang, Y., & Meng, H. (2015). Awareness and completion of advance directives in older Korean‐American adults. Journal of the American Geriatrics Society, 63(3), 565-570.

48.

Downey, L., Curtis, J. R., Lafferty, W. E., Herting, J. R., & Engelberg, R. A. (2010). The Quality of Dying and Death Questionnaire (QODD): Empirical domains and theoretical perspectives. Journal of Pain and Symptom Management, 39(1), 9-22.

49.

Duke, G., Thompson, S., & Hastie, M. (2007). Factors influencing completion of advanced directives in hospitalized patients. International Journal of Palliative Nursing, 13(1), 39-43.

50.

Emanuel, L. L., von Gunten, C. F., & Ferris, F. D. (2000). Advance care planning. Archives of Family Medicine, 9(10), 1181-1187.

51.

Erikson, E. H. (1963). Childhood and society. New York: Norton.

52.

Erickson, J. M., & Erickson, J. M. (1997). The life cycle completed: Extended version with new chapters on the ninth stage of development. New York: Norton.

53.

Fernández, B. R., Warner, L. M., Knoll, N., Montenegro, E. M., & Schwarzer, R. (2015). Synergistic effects of social support and selfefficacy on dietary motivation predicting fruit and vegetable intake. Appetite, 87, 330-335.

54.

Finlay, E., Shreve, S., & Casarett, D. (2008). Nationwide veterans affairs quality measure for cancer: The family assessment of treatment at end of life. Journal of Clinical Oncology, 26(23), 3838-3844.

55.

French, D. P., Olander, E. K., Chisholm, A., & Mc Sharry, J. (2014). Which behaviour change techniques are most effective at increasing older adults’ self-efficacy and physical activity behaviour? A systematic review. Annals of Behavioral Medicine, 48(2), 225-234.

56.

Fried, T. R., Bullock, K., Iannone, L., & O'leary, J. R. (2009). Understanding advance care planning as a process of health behavior change. Journal of the American Geriatrics Society, 57(9), 1547-1555.

57.

Gallant, M. P. (2003). The influence of social support on chronic illness self-management: A review and directions for research. Health Education & Behavior, 30(2), 170-195.

58.

Greenberg, J., Pyszczynski, T., & Solomon, S. (1986). The causes and consequences of a need for self-esteem: A terror management theory. In R. F. Baumeister (Ed.), Public self and private self (pp. 189-212). New York: Springer.

59.

Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling. White paper. Retrieved from http://www.afhayes.com/public/process2012.pdf.

60.

Hebert, R. S., Dang, Q., & Schulz, R. (2006). Preparedness for the death of a loved one and mental health in bereaved caregivers of patients with dementia: Findings from the REACH study. Journal of Palliative Medicine, 9(3), 683-693.

61.

James, J. B., & Zarrett, N. (2006). Ego integrity in the lives of older women. Journal of Adult Development, 13(2), 61-75.

62.

Jang, Y., Park, N. S., Chiriboga, D. A., Radhakrishnan, K., & Kim, M. T. (2017). The Knowing–Doing Gap in Advance Directives in Asian Americans: The role of education and acculturation. American Journal of Hospice and Palliative Medicine, 34(9), 874-879.

63.

Jeong, S. Y. S., Higgins, I., & McMillan, M. (2011). Experiences with advance care planning: Older people and family members’ perspective. International Journal of Older People Nursing, 6(3), 176-186.

64.

Johnstone, M. J., & Kanitsaki, O. (2009). Ethics and advance care planning in a culturally diverse society. Journal of Transcultural Nnursing, 20(4), 405-416.

65.

Kagawa-Singer, M., & Blackhall, L. J. (2001). Negotiating cross-cultural issues at the end of life: You got to go where he lives. Journal of the American Medical Association, 286(23), 2993-3001.

66.

Kahana, B., Dan, A., Kahana, E., & Kercher, K. (2004). The personal and social context of planning for end‐of‐life care. Journal of the American Geriatrics Society, 52(7), 1163-1167.

67.

Kaplan, R. M., Atkins, C. J., & Reinsch, S. (1984). Specific efficacy expectations mediate exercise compliance in patients with COPD. Health psychology, 3(3), 223-242.

68.

Khan, H., Afroz, N., & Chakravarty, J. (2011). Effect of social support on death anxiety among HIV positive people. Social Science International, 27(2), 219-226.

69.

Kim, S. H. (2011). Factors influencing preferences of korean people toward advance directives. Nursing Ethics, 18(4), 505-513.

70.

Krause, S., Rydall, A., Hales, S., Rodin, G., & Lo, C. (2015). Initial validation of the Death and Dying Distress Scale for the assessment of death anxiety in patients with advanced cancer. Journal of Pain and Symptom Management, 49(1), 126-134.

71.

Kwak, J., & Salmon, J. R. (2007). Attitudes and preferences of Korean‐American older adults and caregivers on end‐of‐life care. Journal of the American Geriatrics Society, 55(11), 1867-1872.

72.

Lehto, R., & Therrien, B. (2010). Death concerns among individuals newly diagnosed with lung cancer. Death studies, 34(10), 931-946.

73.

Luo, Y., Hawkley, L. C., Waite, L. J., & Cacioppo, J. T. (2012). Loneliness, health, and mortality in old age: A national longitudinal study. Social Science & Medicine, 74(6), 907-914.

74.

Major, R. J., Whelton, W. J., Schimel, J., & Sharpe, D. (2016). Older adults and the fear of death: The protective function of generativity. Canadian Journal on Aging / La Revue Canadienne Du Vieillissement, 35(2), 261-272.

75.

Martin, D. K., Thiel, E. C., & Singer, P. A. (1999). A new model of advance care planning: observations from people with HIV. Archives of Internal Medicine, 159(1), 86-92.

76.

McCaffrey, N., Bradley, S., Ratcliffe, J., & Currow, D. C. (2016). What aspects of quality of life are important from palliative care patients' perspectives? A systematic review of qualitative research. Journal of Pain and Symptom Management, 52(2), 318-328.

77.

Miyashita, M., Morita, T., Sato, K., Hirai, K., Shima, Y., & Uchitomi, Y. (2008). Good death inventory: A measure for evaluating good death from the bereaved family member's perspective. Journal of Pain and Symptom Management, 35(5), 486-498.

78.

Muramatsu, N., Yin, H., & Hedeker, D. (2010). Functional declines, social support, and mental health in the elderly: Does living in a state supportive of home and community-based services make a difference?. Social Science & Medicine, 70(7), 1050-1508.

79.

Murphy, S. T., Palmer, J. M., Ken, S., Frank, G., Michel, V., & Blackhall, L. J. (1996). Ethnicity and advance care directives. The Journal of Law, Medicine & Ethics, 24(2), 108-117.

80.

Muthén, L. K., & Muthén, B. O. (2012). Mplus Version 7 user’s guide. Los Angeles, CA: Muthén & Muthén.

81.

Newsom, J. T., & Schulz, R. (1996). Social support as a mediator in the relation between functional status and quality of life in older adults. Psychology and Aging, 11(1), 34-44.

82.

Okabayashi, H., Liang, J., Krause, N., Akiyama, H., & Sugisawa, H. (2004). Mental health among older adults in Japan: Do sources of social support and negative interaction make a difference?. Social Science & Medicine, 59(11), 2259-2270.

83.

O'Leary, A. (1985). Self-efficacy and health. Behaviour Research and Therapy, 23(4), 437-451.

84.

Patrick, D. L., Engelberg, R. A., & Curtis, J. R. (2001). Evaluating the quality of dying and death. Journal of Pain and Symptom Management, 22(3), 717-726.

85.

Pautex, S., Herrmann, F. R., & Zulian, G. B. (2008). Role of advance directives in palliative care units: A prospective study. Palliative Medicine, 22(7), 835-841.

86.

Salmond, S. W., & David, E. (2005). Attitudes toward advance directives and advance directive completion rates. Orthopaedic Nursing, 24(2), 117-127.

87.

Seymour, J., Almack, K., & Kennedy, S. (2010). Implementing advance care planning: A qualitative study of community nurses' views and experiences. BMC Palliative Care, 9(1), 4.

88.

Sherer, M., Maddux, J. E., Mercandante, B., Prentice-Dunn, S., Jacobs, B., & Rogers, R. W. (1982). The self-efficacy scale: Construction and validation. Psychological Reports, 51(2), 663-671.

89.

Siedlecki, K. L., Salthouse, T. A., Oishi, S., & Jeswani, S. (2014). The relationship between social support and subjective well-being across age. Social Indicators Research, 117(2), 561-576.

90.

Steinhauser, K. E., Christakis, N. A., Clipp, E. C., McNeilly, M., McIntyre, L., & Tulsky, J. A. (2000). Factors considered important at the end of life by patients, family, physicians, and other care providers. Journal of the American Medical Association, 284(19), 2476-2482.

91.

Steinhauser, K. E., Clipp, E. C., Bosworth, H. B., Mcnelly, M., Christakis, N. A., Voils, C. I., & Tulsky, J. A. (2004). Measuring quality of life at the end of life: Validation of the QUAL-E. Palliative & Supportive Care, 2(1), 3-14.

92.

Stoller, E. P., Kart, C. S., & Portugal, S. S. (1997). Explaining pathways of care taken by elderly people: An analysis of responses to illness symptoms. Sociological Focus, 30(2), 147-165.

93.

Sullivan, D. R., Liu, X., Corwin, D. S., Verceles, A. C., McCurdy, M. T., Pate, D. A., ... Netzer, G. (2012). Learned helplessness among families and surrogate decision-makers of patients admitted to medical, surgical, and trauma ICUs. Chest, 142(6), 1440-1446.

94.

Tilden, V. P., Tolle, S. W., Nelson, C. A., & Fields, J. (2001). Family decision-making to withdraw life-sustaining treatments from hospitalized patients. Nursing Research, 50(2), 105-115.

95.

Tobin, D. L., Reynolds, R. V., Holroyd, K. A., & Creer, T. L. (1986). Self-management and social learning theory. Self-management of chronic disease: Handbook of Clinical Interventions and Research, 39(6), 29-55.

96.

Tong, E., McGraw, S. A., Dobihal, E., & Baggish, R. (2003). What is a good death? Minority and non-minority perspectives. Journal of Palliative Care, 19(3), 168-175.

97.

Tulsky, J. A. (2005). Beyond advance directives: Importance of communication skills at the end of life. Journal of the American Medical Association, 294(3), 359-365.

98.

Warner, L. M., Ziegelmann, J. P., Schüz, B., Wurm, S., & Schwarzer, R. (2011). Synergistic effect of social support and self-efficacy on physical exercise in older adults. Journal of Aging and Physical Activity, 19(3), 249-261.

99.

Westerhof, G. J., Bohlmeijer, E., & Webster, J. D. (2010). Reminiscence and mental health: A review of recent progress in theory, research and interventions. Ageing & Society, 30(4), 697-721.

100.

Wu, A. M. S., Tang, C. K. K., & Kwok, T. C. Y. (2004). Self-efficacy, health locus of control, and psychological distress in elderly Chinese women with chronic illnesses. Aging & Mental Health, 8(1), 21-28.

101.

van Scoy, L. J., Howrylak, J., Nguyen, A., Chen, M., & Sherman, M. (2014). Family structure, experiences with end-of-life decision making, and who asked about advance directives impacts advance directive completion rates. Journal of Palliative Medicine, 17(10), 1099-1106.

102.

Volker, D. L. (2005). Control and end-of-life care: Does ethnicity matter?. American Journal of Hospice and Palliative Medicine, 22(6), 442-446.

103.

Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30-41.

The Korean Journal of Health Psychology