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Table 1. General Characteristics of the Participants (N=161) Characteristics Categories n (%) M±SD Gender Male 13 (8.1) Female 148 (91.9) Age (yrs) 20-24 13 (8.1) 25-29 112 (69.6) 30-34 21 (13.0) 28.18±4.58 35 15 (9.3) Education Associate 3 (1.9) Bachelor 149 (92.5) Master 9 (5.6) Marital status Single 130 (80.7) Married 31 (19.3) Religion In religion 85 (52.8) No religion 76 (47.2) Clinical career (year) <3 years 64 (39.8) 3 or more, less than 6 66 (41.0) 56.69±58.79 6 years 31 (19.3) Current work unit Emergency room 31 (19.3) ICU 39 (24.2) Ward 77 (47.8) Others (OR, DR, etc.) 14 (8.7) Experience with death Yes 47 (29.2) family or relatives during previous 1 year No 114 (70.8) Exposure to 0 44 (27.3) patient death 1 59 (36.6) (1 month average) 2 23 (14.3) 1.60±2.56 (n=155) 3 35 (21.7) Experience with Yes 77 (47.8) education for EoLC No 84 (52.2) Education hours for <8 hours 46 (59.7) EoLC (n=77) 8 hours 31 (40.3) 8.88±12.34 Education routes for EoLC* (n=77) Undergraduate course 55 (71.4) Graduate course 5 (6.5) Refresher education 20 (26.0) Job training 19 (24.7) Hospice institution 4 (5.2) *: more than one answer possible Abbreviations: ICU, Intensive care unit. OR: Operating room. DR: Dialysis room. EoLC: End of life care - 27 -

Table 2. Concept of a Good Death and Attitude Toward Care of the Dying of the Participants (N=161) Variables M±SD Min-Max Possible Item range M±SD Concept of a Good Death 54.14±4.56 42-65 17-68 3.18±0.27 Closure 31.37±2.75 23-36 9-36 3.49±0.31 Personal control 8.49±1.90 3-12 3-12 2.83±0.63 Clinical 14.27±1.92 8-19 5-20 2.85±0.38 Attitude Toward Care of the Dying 91.89±6.83 74-106 30-120 3.06±0.23 Attitude Toward the Patient 59.83±5.18 46-70 20-80 2.99±0.26 Attitude Toward the Family 32.07±2.87 19-38 10-40 3.21±0.29 Table 3. Concept of a Good Death of the Participants (N=161) Subscale Item content M±SD That loved ones be present 3.89±0.31 That the person had an opportunity to say good-bye 3.78±0.46 That it be peaceful 3.74±0.45 That the person be able to accept death 3.72±0.50 Closure That the person's spiritual needs be met 3.67±0.51 That the person had a chance to complete important tasks 3.66±0.54 That family and doctors follow the person's wishes 3.49±0.71 That the person was able to remain at home 2.78±0.74 That the person lived until a key event 2.63±0.76 Personal That the ability to communicate be present until death 3.13±0.73 That there be control of bodily functions until death 2.80±0.76 control That there be mental alertness until the end 2.57±0.74 That it be painless or largely pain-free 3.70±0.55 That it occur naturally, without technical equipment 3.09±0.76 Clinical That the dying period be short 2.89±0.81 That death occurs during sleep 2.84±0.79 That it be sudden and unexpected 1.76±0.80-28 -

Table 4. Attitude Toward Care of the Dying of the Participants (N=161) Subscale Item content M±SD Nurses should permit dying persons to have flexible visiting schedules. 3.76±0.44 The dying person should not be allowed to make decisions about his/her physical care. 3.60±0.64 It is beneficial for the dying person to verbalize his/her feelings. 3.57±0.52 Giving nursing care to the dying person is a worthwhile learning experience. 3.55±0.55 When a patient asks, "Nurse am I dying?", I think it is best to change the subject to something cheerful. 3.43±0.59 I would feel like running away when the person actually died. 3.37±0.79 The nurse should not be the one to talk about death with the dying person. 3.26±0.74 Dying persons should be given honest answers about their condition. 3.21±0.57 Attitude It is possible for nurses to help patients prepare for death. 3.19±0.60 Toward Addiction to pain relieving medication should not be a 3.18±0.93 nursing concern when dealing with a dying person. the There are times when death is welcomed by the dying 3.14±0.56 Patient person. Death is not the worst thing that can happen to a person. 3.06±0.79 I would be upset when the dying person I was caring for gave up hope of getting better. 2.86±0.74 As a patient nears death, the nurse should withdraw from his/her involvement with his/her remaining life. 2.79±0.73 I am afraid to become friends with a dying person. 2.76±0.86 I would hope the person I'm caring for dies when I am not present. 2.74±0.93 I would not want to be assigned to care for a dying person. 2.60±0.84 The length of time required to give nursing care to a dying person would frustrate me. 2.32±0.79 I would be uncomfortable talking about impending death with the dying person. 1.80±0.69 I would be uncomfortable if I entered the room of a terminally ill person and found him/her crying. 1.64±0.68 Attitude Families need emotional support to accept the behavior changes of the dying patient. 3.68±0.48 Toward Nursing care should extend to the family of the dying 3.63±0.59 person. the Families should be concerned about helping their dying Family 3.52±0.60 member make the best of his/her remaining life. - 29 -

Attitude Toward the Family The dying person and his/her family should be the in-charge decision makers. Educating families about death and dying is not a nursing responsibility. Nursing care for the patient's family should continue throughout the period of grief and bereavement. Families should maintain as normal an environment as possible for their dying member. (20) The family should be involved in the physical care of the dying person. (12) Family members who stay close to a dying person often interfere with the professionals' job with the patient. (29) It is difficult to form a close relationship with the family of a dying person.(9) 3.50±0.60 3.47±0.66 3.39±0.67 3.32±0.57 3.26±0.63 2.30±0.70 2.01±0.73-30 -

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Table 5. The Differences of Concept of a Good Death according to General Characteristics of the Participants Characteristics Categories n M±SD t or F (p) Gender Male 13 53.85±3.95 0.24 Female 148 54.16±4.62 (.812) Education Associate 3 51.67±2.89 1.21 Bachelor 149 54.07±4.66 (.301) Master 9 56.00±2.24 Marital status Single 130 53.83±4.57-1.75 Married 31 55.42±4.35 (.081) Religion In religion 85 54.88±4.45 2.22 No religion 76 53.30±4.56 (.028) * Current work unit Emergency room 31 54.74±4.17 ICU 39 52.77±4.20 Ward 77 54.31±4.74 Experience with death family or relatives during previous 1 year Experience with education for EoLC Education routes for EoLC (n=77) Others (OR, DR, etc.) 14 55.64±4.86 Yes 47 53.70±4.76 No 114 54.32±4.48 1.93 (.127) -0.78 (.439) Yes 77 52.95±4.35-3.26 No 84 55.23±4.50 (.001) ** Undergraduate Yes 55 52.45±4.50-1.59 course No 22 54.18±3.75 (.116) Graduate Yes 5 54.80±2.17 0.98 course No 72 52.82±4.44 (.328) Refresher Yes 20 53.75±3.81 0.96 education No 57 52.67±4.52 (.341) Job training Yes 19 52.05±3.39-1.03 No 58 53.24±4.61 (.304) Hospice institution (N=161) Yes 4 58.50±2.65 2.73 No 73 52.64±4.23 (.008) ** * p<.05, ** p<.01 Abbreviations: ICU, Intensive care unit. OR: Operating room. DR: Dialysis room. EoLC: End of life care - 33 -

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Table 6. The Differences of Attitude Toward Care of the Dying according to General Characteristics of the Participants Characteristics Categories n M±SD t or F (p) Gender Male 13 93.08±8.72 0.65 Female 148 91.79±6.66 (.517) Education Associate 3 92.33±4.04 2.50 Bachelor 149 91.59±6.92 (.085) Master 9 96.78±3.53 Marital status Single 130 91.19±6.73-2.76 Married 31 94.87±6.50 (.007) ** Religion In religion 85 92.92±6.32 2.03 No religion 76 90.75±7.22 (.044) * Current work unit Emergency room 31 92.55±7.68 ICU 39 91.41±6.43 Ward 77 91.74±6.41 Experience with death family or relatives during previous 1 year Experience with education for EoLC Education routes for EoLC (n=77) Others (OR, DR, etc.) 14 92.64±8.61 Yes 47 92.30±7.71 No 114 91.73±6.46 (N=161) 0.23 (.878) 0.48 (.632) Yes 77 91.90±6.78 0.00 No 84 91.89±6.91 (.998) Undergraduate Yes 55 91.95±6.67-0.10 course No 22 91.77±7.21 (.920) Graduate Yes 5 98.00±6.67-2.13 course No 72 91.47±6.62 (.036) * Refresher Yes 20 93.40±8.01-1.16 education No 57 91.37±6.29 (.252) Job training Yes 19 93.21±5.16-0.97 No 58 91.47±7.22 (.333) Hospice Yes 4 95.75±6.70-1.17 institution No 73 91.69±6.77 (.246) * p<.05, ** p<.01. Abbreviations: ICU, Intensive care unit. OR: Operating room. DR: Dialysis room. EoLC: End of life care - 35 -

Table 7. The Differences of Subscale of Concept of a Good Death according to General Characteristics of the Participants (N=161) Closure Personal control Clinical Characteristics Categories n M±SD t or F t or F M±SD M±SD t or F (p) (p) (p) Gender Male 13 30.69±2.29 0.93 8.69±2.10-0.40 14.46±1.85-0.37 Female 148 31.43±2.79 (.355) 8.47±1.89 (.691) 14.26±1.93 (.714) Education Associate 3 29.67±2.08 7.67±1.53 14.33±1.53 1.27 1.19 0.01 Bachelor 149 31.34±2.79 8.46±1.91 14.28±1.97 (.284) (.306) (.995) Master 9 32.44±1.94 9.33±1.80 14.22±1.30 Marital status Single 130 31.25±2.76-1.20 8.42±1.93-1.03 14.17±1.88-1.41 Married 31 31.90±2.69 (.234) 8.81±1.78 (.305) 14.71±2.05 (.160) Religion In religion 85 31.84±2.59 2.28 8.65±1.89 1.11 14.40±2.05 0.88 No religion 76 30.86±2.86 (.024) * 8.32±1.91 (.271) 14.13±1.77 (.378) Current work unit Emergency room a 31 31.61±3.01 9.00±1.75 5.14 14.13±1.59 ICU b 39 30.69±2.71 1.44 8.18±1.93 (.002) ** 13.90±2.05 1.05 Ward c 77 31.71±2.57 (.233) 8.17±1.87 (b<d, 14.43±2.02 (.370) Others (OR, DR, etc.) d 14 30.86±3.16 10.00±1.41 c<d) 14.79±1.63 Experience with death Yes 47 30.70±3.02 8.64±1.97 14.36±1.80-2.00 0.63 0.37 family or relatives No 114 31.65±2.60 (.047) * 8.43±1.88 (.529) 14.24±1.98 (.709) during previous 1 year Experience with Yes 77 31.03±2.92-1.54 8.04±1.95-2.96 13.88±1.72-2.51 education for EoLC No 84 31.69±2.56 (.127) 8.90±1.77 (.004) ** 14.63±2.03 (.013) * Education routes U n d e rgraduate Yes 55 30.73±3.02-1.43 8.11±2.11 0.50 13.62±1.72-2.18 for EoLC (n=77) course No 22 31.77±2.60 (.158) 7.86±1.52 (.621) 14.55±1.60 (.032) * - 36 -

Education routes for EoLC (n=77) Graduate course Refresher education Job training Hospice institution * p<.05, ** p<.01, Scheffe test. Yes 5 33.20±1.64 1.74 7.20±1.79-1.00 14.40±1.14 0.69 No 72 30.88±2.94 (.086) 8.10±1.96 (.323) 13.85±1.76 (.492) Yes 20 31.80±2.67 1.38 7.80±1.28-0.80 14.15±1.50 0.80 No 57 30.75±2.98 (.170) 8.12±2.14 (.426) 13.79±1.80 (.425) Yes 19 30.11±2.28-1.60 7.68±1.77-0.91 14.26±1.66 1.11 No 58 31.33±3.06 (.114) 8.16±2.01 (.364) 13.76±1.74 (.271) Yes 4 34.00±2.16 2.73 9.75±1.71 1.83 14.75±1.71 1.03 No 73 30.86±2.88 (.036) * 7.95±1.93 (.071) 13.84±1.72 (.305) - 37 -

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Table 8. The Correlation among Study Variables (N=161) Concept of a Good Death Attitude Toward Variables Care of Total Closure Personal Clinical control the Dying r (p) r (p) r (p) r (p) r (p) Total 1.81 **.58 **.64 **.26 ** (<.001) (<.001) (<.001) (.001) Closure 1.20 *.29 **.24 ** (.010) (<.001) (.002) Personal control 1.09 (.249).08 (.324) Clinical 1.19 * (.014) Attitude Toward Care of the Dying 1 * p<.05, ** p<.01. Table 9. The Predictors of the Attitude Toward Care of the Dying of the Participants (N=161) Variables B SE β t p Tolerance VIF Constant 74.23 5.92 12.53 <.001 ** Closure 0.54 0.19.22 2.88.005 **.991 1.009 Marital status (married) 3.33 1.31.19 2.54.012 **.991 1.009 ** p<.01. - 40 -

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