The Influence of Social Support among Community Dwelling Elderly and their Attitude towards the Withdrawal of Life-sustaining Treatment: A Mediating Effect of Self-esteem.

Purpose: The purpose of this study was to examine the mediation of Self-Esteem in the relationship between Social Support and attitude toward the Withdrawal of Life-Sustaining Treatment (WLST) for community dwelling elderly in order to provide a basis for planning nursing interventions to improve the attitude of elderly. Methods: The participants were 252 elderly residing in Seoul. The data were collected through a questionnaire survey distributed in March, 2016. The survey included scales on Social Support, attitude towards WLST and measures of Self-esteem. Collected data were analyzed using SPSS/WIN 21.0 program. Results: The mean score for the attitude towards WLST was 73.83. Self-Esteem was 29.44. Overall Social Support was 42.51. There were significant correlations among the three variables. Self-esteem was directly affected by the attitude (R² =24%). Attitude towards WLST was directly affected by Family Support. Family Support and Self-esteem affected by the attitude on WLST (R² =19%). Self-esteem had a partial mediating effect (β=.23, p<.001) in the relationship between Family Support and reported attitude from the WLST (Sobel test: Z=4.93, p<.001). Conclusion: Based on the findings of this study, programs can be created focusing on Social Support and Self-Esteem improvement. The programs may positively change the elderly's attitude towards WLST. [ABSTRACT FROM AUTHOR]