DOI QR코드

DOI QR Code

종합병원 간호사의 연명의료 간호역할 인식, 좋은 죽음 인식이 연명의료 간호 스트레스에 미치는 영향

The Relationshipof Role Perception of Life-Sustaining Treatment and Good Death Perception with Nursing Stress on Life-Sustaining Treatment in General Hospital Nurses

  • Kim, Su Hyun (Department of Nursing, Chungnam National University Hospital) ;
  • Jung, Mi Sook (College of Nursing, Chungnam National University) ;
  • Jang, Myoungock (College of Nursing, Chungnam National University)
  • 투고 : 2022.09.29
  • 심사 : 2022.10.24
  • 발행 : 2022.12.31

초록

Purpose: Nursing stress on life-sustaining treatment of nurses is a significant contributing factor to nursing care performance and patient care outcomes. We need to investigate the factors associated with nursing stress on life-sustaining treatment in hospital settings. The purpose of this descriptive study was to examine the relationship of role perception of life-sustaining treatment and good death perception with nursing stress on life-sustaining treatment among nurses in hospital settings. Methods: Using a cross-sectional study design, we recruited nurses at a hospital located in a metropolitan city in Korea. The nurses completed structured questionnaire questions which were composed of well-validated questionnaires. Descriptive statistics and hierarchical multiple regression model were utilized for data analysis. Results: A total of 205 nurses participated in the study (female 93.2%; aged 20~29 years 63.0%; single status 78.5%). In the hierarchical multiple regression model, there was a significant positive relationship between role perception of life-sustaining treatment and nursing stress on life-sustaining treatment (β=.27, p<.001). Higher education level and working at a ward setting were also significantly related to nursing stress on life-sustaining treatment (β=.13, p<.046 for education level; β=.22, p=.001 for work setting). However, there was no relationship between good death perception and nursing stress on life-sustaining treatment. Conclusion: Education programs to reduce nursing stress on life-sustaining treatment are needed to develop for nurses who have higher role perception of life-sustaining treatment with higher education level working at ward settings in hospitals.

키워드

참고문헌

  1. Kang JH, Han SJ. A Study of intensive care unit nurses' understanding of the meaning of death, death anxiety, death concern and respect for life. Korean Journal of Hospice and Palliative Care. 2013;16(2):80-89. https://doi.org/10.14475/kjhpc.2013.16.2.080
  2. Statistics Korea. Statistics for motality in 2020 [Internet]. Daejeon: Statistics Korea; 2021 Sep 27 [cited 2022 Apr 8]. Available from: https://kostat.go.kr/portal/korea/kor_nw/1/1/index.board?bmode=read&aSeq=403046.
  3. Browning AM. CNE article: Moral distress and psychological empowerment in critical care nurses caring for adults at end of life. American Journal of Critical Care. 2013;22(2):143-151. https://doi.org/10.4037/ajcc2013437
  4. Korean National Institute for Bioethics Policy. Two years since the implementation of the life-sustaining medical decision system, the use of the system continues to increase [Internet]. Seoul: Korean National Institute for Bioethics Policy; 2020 Feb 4 [cited 2022 Apr 2]. Available from: https://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_M ENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=3526 77&SEARCHKEY=TITLE&SEARCHVALUE=%EC%97%B0 %EB%AA%85.
  5. Lee SJ, Kim HY. Experience of life-sustaining treatment in patient care among intensive care unit nurses: Phenomenological approach. Journal of Korean Academy of Fundamentals of Nursing. 2016;23(2):172-183. https://doi.org/10.7739/jkafn.2016.23.2.172
  6. Lee SJ, Kim HY. Attitude, role perception and nursing stress on life sustaining treatment among intensive care unit nurses. Korean Journal of Adult Nursing. 2017;29(2):131-142. https://doi.org/10.7475/kjan.2017.29.2.131
  7. Ko MJ, Moon SH. Factors influencing performance of end-of-life care by ICU nurses. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2016;25(4):327-337. https://doi.org/10.12934/jkpmhn.2016.25.4.327
  8. Kim SK, Kim SH, Yun HY. Factors that influence end-of-life care provided by nurses in general hospitals. Korean Journal of Medical Ethics. 2019;22(1):53-72. https://doi.org/10.35301/ksme.2019.22.1.53
  9. Taylor IH, Dihle A, Hofso K, Steindal SA. Intensive care nurses' experiences of withdrawal of life-sustaining treatments in intensive care patients: A qualitative study. Intensive and Critical Care Nursing. 2020;56:102768. https://doi.org/10.1016/j.iccn.2019.102768
  10. Birchley G. Doctor? Who? Nurses, patient's best interests and treatment withdrawal: When no doctor is available, should nurses withdraw treatment from patients? Nursing Philosophy. 2013;14(2):96-108. https://doi.org/10.1111/j.1466-769X.2012.00553.x
  11. Zuleta-Benjumea A, Munoz SM, Velez MC, Krikorian A. Level of knowledge, emotional impact and perception about the role of nursing professionals concerning palliative sedation. Journal of Clinical Nursing. 2018;27(21-22):3968-3978. https://doi.org/10.1111/jocn.14582
  12. Choi JH, Choi ES. Trends in nursing research on life-sustaining treatment in South Korea after the enforcement of the Act on Decisions on Life-Sustaining Treatment. Journal of Hospice and Palliative Care. 2022;25(1):25-41. https://doi.org/10.14475/jhpc.2022.25.1.25
  13. Lee MR. Attitude, role perception and nursing stress on life sustaining treatment of nurses. Journal of Digital Convertgence. 2020;18(7):347-355. https://doi.org/10.14400/JDC.2020.18.7.347
  14. Son YJ, Park JS. Effects of perception of death, terminal care stress, and resilience on the terminal care performance of clinical nurses. Journal of East-West Nursing Research. 2021;27 (2):124-133. https://doi.org/10.14370/jewnr.2021.27.2.124
  15. Noh SS, Lee CK, Sung YH. Predictors of terminal care performance of clinical nurses for cancer patients. Journal of Korean Critical Care Nursing. 2016;9(2):61-70.
  16. Song EH, Lee HK. Effects of good death awareness and spiritual well-being on elderly nursing performance of geriatric hospital nursing providers. Journal of the Korean Applied Science and Technology. 2019;36(3):975-984. https://doi.org/10.12925/jkocs.2019.36.3.975
  17. Lee KJ, Hwang KH, Park JS, La JR, Hong JA. Concept analysis of good death. Hospice/Palliative Care of the Catholic University of Korea. 2006;10(1):23-39.
  18. Kim SH, Kim EY. Effects of awareness of good death and end-of-life care attitudes on end-of-life care performance in long-term care hospital nurses. Journal of Hospice and Palliative Care. 2021;24(1):26-35. https://doi.org/10.14475/jhpc.2021.24.1.26
  19. Kim OJ. Intensive care nurses' good death awareness, end-oflife care stress, and end-of-life care competency [master's thesis]. Pusan: Catholic University of Pusan; 2020. p. 1-83.
  20. Hwang JO, Kim SH. Influence of death perception, attitude toward terminal care, mental health on the terminal care stress of intensive care unit nurses. Journal of Korean Clinical Nursing Research. 2019;25(3):323-332. https://doi.org/10.22650/JKCNR.2019.25.3.323
  21. Byun EK, Choi HR, Choi AL, Hong KH, Kim NM, Kim HS. An investigative research on the attitudes of intensive care unit nurses and families on terminating life support. Journal of Korean Clinical Nursing Research. 2003;9(1):112-124.
  22. Schwartz CE, Mazor K, Rogers J, Ma Y, Reed G. Validation of a new measure of concept of a good death. Journal of Palliative Medicine. 2003;6(4):575-584. https://doi.org/10.1089/109662103768253687
  23. Lee SH. Concept of a good death and attitude toward care of the dying in general hospital nurses [master's thesis]. Seoul: Seoul National University; 2017. p. 1-78.
  24. Choi SY, Kim KH. The influence of moral sensitivity, knowledge of advanced directives, good death perception on nurses' attitudes toward the withdrawal of life-sustaining treatment in a general hospital. Korean Journal of Rehabilitation Nursing. 2020;23(2):120-131. https://doi.org/10.7587/kjrehn.2020.120
  25. Cho EA, Ki JS. Effects of perception of good death and knowledge toward advance directive on attitude toward withdrawal of life-sustaining treatment among university hospital nurses. Journal of the Korea Contents Association. 2021;21 (4):688-698. https://doi.org/10.5392/JKCA.2021.21.04.688
  26. Kang JH, Han SJ. A study of intensive care unit nurses' understanding of the meaning of death, death anxiety, death concern and respect for life. Journal of Hospice and Palliative Care. 2013;16(2):80-89. https://doi.org/10.14475/kjhpc.2013.16.2.080
  27. Um JK, Suh GH, Park SA. Life-sustaining treatment attitude, stress and advanced directives awareness in ICU nurses. Journal of the Korea Bioethics Association. 2018;19(1):37-50. https://doi.org/10.37305/JKBA.2018.06.19.1.37
  28. De Villers MJ, DeVon HA. Moral distress and avoidance behavior in nurses working in critical care and noncritical care units. Nursing Ethics. 2013;20(5):589-603. https://doi.org/10.1177/0969733012452882
  29. Pak SY. Issues and challenges of nursing workforce supply to improve the quality of health care services. Korean Journal of Converging Humanities. 2018;6(1):31-54. https://doi.org/10.14729/converging.k.2018.6.1.31