Korean J Fam Pract 2019; 9(3): 303-310  https://doi.org/10.21215/kjfp.2019.9.3.303
Communication about Death and Confidence Levels concerning Death-Related Issues among Koreans
Jaewon Lee1, Jiwon Kim1, Tae-Suk Kim1,2, Chulmin Kim1,3,*
1College of Medicine, The Catholic University of Korea; Departments of 2Psychiatry and 3Family Medicine, Seoul St. Mary’s Hospital, Seoul, Korea
Chulmin Kim
Tel: +82-2-2258-1760, Fax: +82-2-2258-1903
E-mail: musofm@catholic.ac.kr
Jaewon Lee and Jiwon Kim contributed equally to this study.
Received: August 27, 2018; Revised: October 8, 2018; Accepted: November 1, 2018; Published online: June 20, 2019.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: This study investigated the current status of communication about death and confidence levels concerning death-related issues among Korean adults.
Methods: A survey was conducted to ascertain the frequency of death related communication, factors promoting and impeding such communication, and confidence levels concerning death-related issues. Data of 112 participants who completed the survey were analyzed using descriptive statistics, a chi square test, and multiple logistic regression.
Results: More than half of the participants (52.7%?84.0%) appeared to have infrequent (never/at least one) conversations about death or death-related issues. Owing to socio-cultural aspects, death-related communication was considered a taboo or an unpleasant topic of conversation. Additionally, indifference toward death inhibited people from communicating; however, personal experiences of death or morbidity and favorable social contexts promoted communication. Overall, the confidence levels concerning death-related issues was low. Only 17.9%?32.2% of the participants were confident/very confident about their preferences concerning death-related issues. The more people talked about death, the more likely they were to develop a confident attitude toward death-related issues (odds ratio, 3.45; 95% confidence interval, 1.37?8.69).
Conclusion: This study confirmed that communication about death is being withheld among Koreans, and this could possibly lower their level of confidence regarding death-related issues. To achieve death with dignity, a ‘death culture’ needs to be promoted alongside legislation and infrastructure.
Keywords: Death; Attitude to Death; Death with Dignity; Communication; Personal Autonomy; Value System; Terminal Care; Advance Care Planning
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