2. Materials and Methods
2.1. Study Design
2.3. Data Collection
2.4. Data Analysis
3.1. Sample Description
3.2. Thematic Analysis
3.3. Category 1: Needs for Life-Sustaining Treatment
- Theme cluster 1: Main decision-maker for life-sustaining treatment
“Children can’t just give up on their parents…I should tell my kids that if mom and dad suddenly collapses, we don’t want life-sustaining treatment”(older adult 6).
- Theme cluster 2: Factors involved in choosing life-sustaining treatment
“Drilling a hole in your throat—that’s not really what I want. There is no use to just sustain your life like that”(middle-aged adult 4).
“People especially don’t want to become a burden when they become old…they want to leave at least a little money and not become dead weight. It’s the same for everyone”(middle-aged adult 9).
- Theme cluster 3: Desired healthcare at end of life
“…They’re not gonna live for a year or two; they just have to live a day or two, huh? It just doesn’t work ’cause it’s so painful”(older adult 6).
3.4. Category 2: Needs for Physical Care
- Theme cluster 1: Maintain a good shape
“I just wish to have all the basic necessities taken care of. Just clean me often and change my diapers often”(middle-aged adult 5).
“They don’t change diapers often…I hate bedsores! I’d want to die if I have that”(middle-aged adult 6).
- Theme cluster 2: Wish to be protected
“You fall from your bed and get fractures in the blink of an eye…So you need to be tied up [with physical restraints] if you don’t want to be hurt”(older adult 12).
- Theme cluster 3: Dynamic activities
“I have no intent to remain in a ward and lying down on a bed. I just want to go outside, even just a little bit, when I am still capable of walking on my feet and get some fresh air”(older adult 12).
- Theme cluster 4: Personally preferred physical care
“Even if eating this would be bad for my health, I want it when I like it at the moment. I’m going to die anyway”(middle-aged adult 6).
3.5. Category 3: Needs for Emotional Care
- Theme cluster 1: Supportive care to protect against the fear of death
“I wish they would let me know that I’m not alone. I wish they would help me feel relaxed. So that I won’t be nervous. So that I could depend on them”(young adult 4).
“Thinking that I will die. I think I’ll be so lonely. I think I’m going to be really lonely; so, I wish my close friends would visit me often to say, ‘hi’”(middle-aged adult 7).
- Theme cluster 2: Religious care
“No matter if you have a religion or not, you get to look back at your life when you die. People suddenly confess their sins…For example, If I believe (in God) but my mom doesn’t, then when the pastors come to my mom nearing her death then she suddenly develops faith. Because they tell you that you will go to heaven when you die”(young adult 9).
“I transcribed the entire Bible, and I wish that someone would bring that notebook and read it for me—even if I’m not conscious”(older adult 1).
3.6. Category 4: Environmental Needs
- Theme cluster 1: Independent space
“I think it would be difficult on me to see the whole ward be depressed and sad because of my death. Everybody here is sick, and when they become sad, they can be even more depressed…”(young adult 9).
“I don’t want to have to be forced to get along with other people…I wish that people have their private spaces and just gather when we have to”(middle-aged adult 5).
- Theme cluster 2: Familiar environment
“I wish I would spend the later days of my life at a place where I lived for a long time and where I have all the memories. I want to go back to my hometown and remind myself of the memories and not stay in the hospital…”(young adult 10).
- Theme cluster 3: Personally preferred environment
“When you’re lying down, the people you miss the most are your grandchildren and immediate family…”(older adult 9).
“I wish it would be a place where people can often come, and friends can come and go”(young adult 6).
- Theme cluster 4: Want to choose one’s care provider
“Nurses or care provider[s] can wash me and change my diapers; but I think it would be difficult for them to do that for me without making me feel embarrassed. So, I wish my family would do that for me if I am conscious at all”(young adult 2).
“The problem is whether they treat patients who are admitted [to the hospital] nicely. You never know how they [care providers] will treat patients”(middle-aged adult 7).
3.7. Category 5: Needs for Respect
- Theme cluster 1: Respectful treatment
“I wish the healthcare providers wouldn’t be so cold…”(older adult 13).
“I don’t want people around me to be interested in me so much. It’s enough that I worry about death and if I make people around me worry. They have their own lives; so, I want them to be polite but not care about me too much”(young adult 3).
- Theme cluster 2: Physical respect
“I don’t want people to see me like that…If death is near, you only have your bones left. You look like a ghost and not a grandfather”(older adult 9).
3.8. Category 6: Needs for Preparation for Death
- Theme cluster 1: Accept death
“Practice to end bonds with life and children, I want to practice [those] kind[s] of things”(middle-aged adult 5).
“I want to go in my bed, my eyes closed, and be farewelled by my family. I want to go when it is time…I want to see death as a joyful thing and don’t want to fear it”(young adult 4).
- Theme cluster 2: Meeting and talking
“I’m just curious how my family, friends, and people around me would judge me after I die…The Korean culture is not like where you talk about everything with your family”(middle-aged adult 6).
“I think it would be too much of a burden if I ask before I die. I want to say things like, ‘I was happy to be with you.’ ‘Don’t be sad’”(middle-aged adult 5).
- Theme cluster 3: Remember me
“If I have a care provider, I wish they would tell people who visit me that I am at peace even if I’m not conscious. I wish they would tell people not to worry or be sad. And even if some family members couldn’t stay beside me at my deathbed, I wish people would tell them that I went in peace because they could feel sad—at least at the funeral”(middle-aged adult 7).
- Theme cluster 4: Have affairs in order
“I wish they would clean up my house or room”(middle-aged adult 6).
“I think I would deal with my cell phone first. Tell my family the password. Let them know who to contact”(middle-aged adult 7).
- Theme cluster 5: Arrange for postmortem affairs
“I should be cremated. I want that and I don’t need any memorial ceremonies or what not”(older adult 3).
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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(n = 10)
(n = 12)
(n = 15)
|Age (years)||Mean (SD)||24.6 (1.6)||46.0 (10.3)||65.5 (3.5)|
|Needs for life-sustaining treatment||Main decision-maker for life-sustaining treatment|
|Factors involved in choosing life-sustaining treatment|
|Desired healthcare at end of life|
|Needs for physical care||Maintain a good shape|
|Wish to be protected|
|Personally preferred physical care|
|Needs for emotional care||Supportive care to protect against the fear of death|
|Environmental needs||Independent space|
|Personally preferred environment|
|Want to choose one’s care provider|
|Needs for respect||Respectful treatment|
|Needs for preparation for death||Accept death|
|Meeting and talking|
|Have affairs in order|
|Arrange for postmortem affairs|
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