요양병원간호사와 간호제공자의 임종간호스트레스와 임종간호수행비교

정지수 사단법인 한국융합기술연구학회 2023 아시아태평양융합연구교류논문지 Vol.9 No.1

The purpose of this study was a descriptive research to investigate the relationship between terminal care stress and terminal carer of long-term care hospital nurses and nursing staff. Through this study, we tried to provide terminal Care management plans suitable for the situation of long-term care hospital and basic data necessary for terminal Care education. Data collection was from August 2020 to February 2021, and was conducted on 245 long-term care hospital nurses and nursing staff working at S city long-term care hospitals. This study collected data analyzed them with descriptive statistic, t-test, χ2, ANOVA, Pearson's correlation coefficient by using SPSS 20.0 program. As a result, terminal care stress of long-term care hospital nurses and nursing staff was high, and the terminal care score was 3.29 and 3.35. In the terminal care score of nursing staff was significantly higher than long-term care hospital nurses. There was a significant positive correlation between Long-term care hospital nurses of terminal care stress and terminal care. Therefore, this will require a management plan for the long-term care hospital nurses, terminal care education should be developed for long-term care hospital nurses and nursing staff. 본 연구는 요양병원간호사와 간호제공자의 임종간호스트레스와 임종간호수행 정도를 비교하고 두 군 간의 관계 및 차이를 파악하여 요양병원 실정에 맞는 임종간호 관리방안과, 임종간호 교육에 필요한 기초자료를 제공하고자 시도된 서술적 조사연구이다. 자료 수집은 2020년 8월부터 2021년 2월까지로 S시 요양병원에 근무하는 간호사와 간호제공자 245명을 대상으로 실시하였다. 자료처리는 SPSS 20.0 프로그램을 이용하여 t-test, χ2, ANOVA, Pearson's 상관관계로 분석하였다. 연구결과 요양병원간호사와 간호제공자의 임종간호스트레스는 높은 수준 이었으며, 임종간호수행 점수는 3.29점, 3.35점으로 간호제공자의 점수가 유의하게 높았다. 요양병원간호사의 임종간호스트레스와 임종간호수행은 유의한 양의 상관관계를 나타냈다. 이에 요양병원 실정에 맞는 임종간호 관리 및 임종간호 교육이 개발되어야 할 것이다.

임상간호사의 죽음인식, 임종간호스트레스와 회복탄력성이 임종간호수행에 미치는 영향

손유정 ( Son¸ Yu-jung ),박정숙 ( Park¸ Jung Suk ) 경희대학교 동서간호학연구소 2021 동서간호학연구지 Vol.27 No.2

Purpose: This study examined the effects of death perception, terminal care stress, and resilience on the terminal care performance of clinical nurses. Methods: As a correlational study, this study conducted a survey total of 189 nurses working at K university hospital and a P university hospital in B metropolitan city for six months or more. The data was collected from August 20th, 2020 to September 15th, 2020. Data were analyzed using the SPSS, Windows version 25.0, according to the purpose of the analysis by descriptive statistics, t-test, ANOVA, Scheffe test, Pearson’s correlation coefficient, and hierarchical multiple linear regression. Results: The factors having effects on the terminal care performance of subjects were resilience, perception of death, and the experience of terminal care education. The total explanatory power of those variables on the terminal care performance was 21.0%. Conclusion: For the improvement of terminal care performance, it would be necessary to develop a systematic and professional terminal care education program that could increase the positive perception of death and resilience, and also include knowledge and skills necessary for terminal care. Also, the efficiency of terminal care performance should be increased through periodic terminal care-related nursing education.

임상간호사의 임종간호수행에 미치는 영향요인

구연희(Yeonhee Koo),민해영(Haeyoung Min) 한국자료분석학회 2023 Journal of the Korean Data Analysis Society Vol.25 No.5

본 연구는 임상간호사의 긍정심리자본, 임종간호스트레스와 환자-가족 중심 간호에 대한 인식이 임종간호수행에 미치는 영향을 규명하고자 시도되었다. G도 J시에 소재한 일개의 상급종합병원에서 근무하는 총 임상경력 12개월 이상인 임종환자를 1회 이상 간호한 경험이 있는 간호사를 대상으로 자료를 수집하였다. 연구대상자는 총 193명이고, 수집된 자료는 SPSS/WIN 25.0 프로그램을 활용하여 실수와 백분율, 표준편차, independent t-test, one-way ANOVA, Scheffé test 사후검증, Pearson’s correlation coefficient, stepwise multiple regression analysis로 분석하였다. 대상자의 임종간호수행은 현부서 경력(F=3.60, p=.015), 근무부서(t=2.36, p=.019), 1년 이내 임종환자 간호제공횟수(F=2.76, p=.044), 환자-가족 중심 간호교육 경험(t=-2.26, p=.025)에 따라 유의한 차이가 있었다. 임상간호사의 임종간호수행의 영향요인을 확인하기 위해 단계별 회귀분석을 실시한 결과, 긍정심리자본(β=.38, p<.001), 환자-가족 중심 간호에 대한 인식(β=.23, p=.001), 근무부서(β=.15, p=.014), 환자-가족 중심 간호 교육경험(β=.14, p=.026)이 임종간호수행에 영향을 미치는 요인을 확인되었으며 전체 설명력은 29.0%로 나타났다(F=20.57, p<.001). 따라서 임종간호수행을 증진하기위해 임상간호사의 긍정심리자본, 환자-가족 중심 간호에 대한 인식 및 환자-가족 중심 간호교육경험을 높이는 효과적인 교육 프로그램이 제공되어야 할 것이다. The purpose of this study was to examine the effects of clinical nurses’ positive psychological capital, terminal care stress and perception of patient-family centered care on performance of terminal care. Data were collected from 198 nurses, and analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and stepwise multiple regression analysis. There were significant differences between clinical nurses’ performance of terminal care and working experiences in current unit (F=3.60, p=.015), work unit (t=2.36, p=.019), number of terminal care provided to dying patients within 1 year (F=2.76, p=.044), and experience of patient-family centered care education (t=-2.26, p=.025). The factors affecting clinical nurse’s performance of terminal care were positive psychological capital (β=.38, p<.001), perception of patient-family centered care (β =.23, p=.001), work unit (β=.15, p=.014), and experience of patient-family centered care education (β=.14, p=.026), explaining 29.0% of the variance. Therefore, the effective education program is needed to enhance clinical nurses’ positive psychological capital as well as to increase their education experience and awareness of patient-family centered care in order to better perform terminal care.

Effects of Death Anxiety and Perceived End-of-Life Care Competencies on Fear of Terminal Care among Clinical Nurses

Heewon Kim,So-Hi Kwon 한국호스피스완화의료학회 2023 한국호스피스.완화의료학회지 Vol.26 No.4

Purpose: The aim of this study was to examine the effects of death anxiety and perceived end-of-life care competencies on the fear of terminal care among clinical nurses. Methods: This correlational study was conducted from June to July 2021. The study included 149 clinical nurses employed at a tertiary hospital and seven other hospitals. The measurement tools used in this study were the Thanatophobia Scale (Cronbach’s α=0.87), the Death Anxiety Scale (Cronbach’s α=0.80), and the Scale of End-of-life Care Competencies (Cronbach’s α=0.94). These instruments were chosen to assess the levels of fear of terminal care, death-related anxiety, and competencies in end-of-life care. Results: The mean score for fear of terminal care was 3.32±1.32. Differences in fear of terminal care were observed based on the working unit, position, number of patients requiring terminal care, and experience with end-of-life care education. Fear of terminal care was significantly positively correlated with death anxiety and significantly negatively correlated with end-of-life care competencies. In multiple regression analysis, the factors influencing fear of terminal care were attitudes toward end-of-life care competencies (β=-0.39, P<0.001), death anxiety (β=0.24, P<0.001), knowledge of end-of-life care competencies (β=-0.22, P=0.005), and behaviors related to end-of-life care competencies (β=-0.16, P=0.021). These factors explained 64.6% of the total variance (F=25.54, P<0.001). Conclusion: This study suggests that developing nurses’ end-of-life care competencies and reducing death anxiety are crucial for managing the fear of terminal care. Therefore, providing end-of-life care education and psychological support programs is important.

Terminal cancer patients’ and their primary caregivers’ attitudes toward hospice/palliative care and their effects on actual utilization: A prospective cohort study

An, Ah Reum,Lee, June-Koo,Yun, Young Ho,Heo, Dae Seog SAGE Publications 2014 Palliative medicine Vol.28 No.7

<P><B>Background:</B></P><P>Previous studies on hospice/palliative care indicated that patients’ socio-demographic factors, disease status, and availability of health-care resources were associated with hospice/palliative care utilization. However, the impact of family caregivers on hospice/palliative care utilization has not been thoroughly investigated.</P><P><B>Aim:</B></P><P>To evaluate the association between attitudes toward hospice/palliative care of both patients with terminal cancer (defined as progressive, advanced cancer in which the patient will die within months) and their family caregivers and utilization of inpatient hospice/palliative care facilities.</P><P><B>Design:</B></P><P>A prospective observational cohort study was performed in 12 hospitals in South Korea. Attitude toward hospice/palliative care was assessed immediately after terminal cancer diagnosis. After the patient’s death, caregivers were interviewed whether they utilized hospice/palliative care facilities.</P><P><B>Participants:</B></P><P>A total of 359 patient–caregiver dyads completed baseline questionnaires. After the patients’ death, 257 caregivers were interviewed.</P><P><B>Results:</B></P><P>At the baseline questionnaire, 137/359 (38.2%) patients and 185/359 (51.5%) of caregivers preferred hospice/palliative care. Preference for hospice/palliative care was associated with awareness of terminal status among both patients (adjusted odds ratio: 1.87, 95% confidence interval: 1.16–3.03) and caregivers (adjusted odds ratio: 2.14, 95% confidence interval: 1.20–3.81). Religion, metastasis, and poor performance status were also independently associated with patient preference for hospice/palliative care. At the post-bereavement interview, 104/257 (40.5%) caregivers responded that they utilized hospice/palliative care facilities. Caregiver’s preferences for hospice/palliative care were significantly associated with actual utilization (adjusted odds ratio: 2.67, 95% confidence interval: 1.53–4.67). No patient-related factors were associated with hospice/palliative care utilization.</P><P><B>Conclusion:</B></P><P>Promoting awareness of prognosis and to improve communication between doctors and families is important for facilitating the use of hospice/palliative care.</P>

종합병원간호사의 DNR(Do-not- resuscitate)에 대한 윤리적 태도와 임종간호수행에 관한 연구

손유림,서영숙,Son, Yu-Lim,Seo, Young-Sook 한국임상보건과학회 2015 한국임상보건과학회지 Vol.3 No.2

Purpose. The purposed of this study was done to DNR attitude and terminal care performance among hospital nurses. Methods. The participants were 207 nurses working in hospital nurses in D and G cities. Data on DNR attitude and terminal care performance were collected via questionnaire between April 2015 and July 2015. Data analysis was done with SPSS 12.0 program and included one-way ANOVA, independent t-test, and Pearson correlation. Result. DNR attitude of participants in this study were shown to have high levels (DNR attitude: M=32.64/60, SD=6.14). Terminal care performance of participants in this study were shown to have poor levels (physical M=20.72/32, SD=3.77, psychological M=20.26/32, SD=3.85, spiritual M=9.62/24, SD=3.65). The attitude of the hospital nurse was significantly different according to the marital status. The terminal care performance was significantly different according to experience of terminal care. The DNR attitude by nurses was positively correlation to physioloical terminal care performance(r=.137, p<.049) but the relationship between the psychological terminal care performance( r=.016, p=.815) and spiritual terminal care performance showed no correlation(r=-.099, p=.157). Conclusion. The results of this study indicate that it is necessary to increase DNR attitude and to encourage terminal care performance among hospital nurses.

가정전문간호사의 죽음인식과 죽음 불안이 임종간호태도에 미치는 영향

김숙희 한국가정간호학회 2022 가정간호학회지 Vol.29 No.3

Purpose: The purpose of this study was to identify the extent to which in-hospital-based home health nurses’ perceptions and anxiety about death following terminal care, affects their attitudes toward terminal care. Methods: The subjects were 128 advanced practice nurses working in hospital-based facilities for home health care, located in Seoul, Gyeonggi-do, and Incheon Metropolitan City. Data were collected from May 3, 2019, to June 3, 2019, using structured questionnaires, on terminal care and related variables based on the literature. Data were analyzed by performing the Student’s t-test, one-way ANOVA, Pearson’s correlation, and multivariable stepwise regression using the SPSS Version 25.0 program. Results: The scores of the attitudes toward terminal care of home health care nurses was 3.25 points out of a possible 4 points. Factors affecting nurses’ attitudes toward terminal care were their concern about death(β=0.45, p<0.001), religion(β=-0.26, p=0.001) and the anxiety of others about dying(β=-0.23, p=0.003), which explained 32.0% of the observed variance concerning the factors affecting nurses’ attitudes toward terminal care. Conclusion: Through this study, concern about death, anxiety about how other people process dying, and religion, were found to be associated factors. The more concerned the nurses were about death and the less their anxiety about how others process dying, the better the home health care nurses’ attitude toward implementing terminal care. .

임종간호 태도에 영향을 미치는 융합적인 요인분석

양승애 한국융합학회 2015 한국융합학회논문지 Vol.6 No.4

본 연구는 임종간호 태도에 영향을 미치는 요인들을 파악하기 위하여 시도하였다. 연구 대상은 종합병원에 근무하고 있는 간호사 190명이였으며 측정 도구는 죽음에 대한 인식, 죽음불안, 임종간호 스트레스, 죽음에 대한 태도, 소진, 임종간호 태도에 관한 문항으로 구성되었다. 죽음에 대한 인식, 죽음불안, 임종간호 스트레스, 죽음에 대한 태도, 소진, 임종간호 태도정도는 기술통계로 분석하였고 제 변수들 간의 상관관계는 Pearson correlation coefficients, 임종간호 태도에 영향을 미치는 요인은 다중 선형 회귀분석(Multiple linear regression)을 적용하였다. 임종간호 태도는 죽음에 대한 인식, 임종간호 스트레스와 유의한 정적상관성이 있는 것으로 나타났으며 죽음 불안, 죽음에 대한 태도, 소진과는 유의한 부적 상관성이 있는 것으로 나타났다. 죽음에 대한 인식, 죽음 불안, 임종간호 스트레스, 죽음에 대한 태도 등이 유의미한 영향을 주는 것으로 나타나 임종간호 태도의 32.7%를 설명하였다. 본 연구 결과를 토대로 실제적인 임종간호 교육프로그램 개발에 활용할 수 있을 것이다. Objectives: The purpose of the study was to identify factors influencing on nurses’ Terminal Care Attitude. Methods: A sample of convenience of 190 nurses. Instrument included perception of death, death anxiety, terminal care stress, death attitude, burnout, terminal care attitude. Results: A significant positive correlation was found among terminal care attitude, perception of death, terminal care stress. In addition, a significant negative correlation was found among terminal care attitude, death anxiety, death attitude, burnout. Perception of death, death anxiety, terminal care stress & death attitude were significant predictive variables. This variables accounted for 32.7% of the variance in terminal care attitude. Conclusions: Based on the Findings of this study, it can be used to develop educational programs for Terminal Care.

중환자실 간호사의 임종간호수행에 영향을 미치는 요인

고문정 ( Ko Mun Jung ),문소현 ( Moon So-hyun ) 한국간호과학회 정신간호학회(구 대한간호학회정신간호학회) 2016 정신간호학회지 Vol.25 No.4

Purpose: This study was a descriptive research to assess the level of and the relationship of related factors in the performance of end-of-life care by intensive care unit (ICU) nurses. Methods: Participants were 238 ICU nurses from university and general hospitals. Data were collected, using structured questionnaires, and collected data were analyzed using t-test, ANOVA, Scheffe test, Pearson correlation coefficients, and multiple regression analysis with SPSS/WIN 22.0. Results: There were significantly positive effects between performance of end-of-life care and end-of-life care attitudes. Performance end-of-life care was negatively associated with end-of-life care stress and obstacles. Factors that significantly influenced ICU nurses` performance of end-of-life were end-of-life care stress, medical team in obstacles related to end-of-life care, and end-of-life care attitudes, which explained about 53% of the variance in the performance of end-of-life care. Conclusion: Findings indicate that hospital organizations should carry out stress management and counseling programs in order to lower ICU nurses` end-of-life care stress, and to enhance end-of-life care attitudes. In addition, concern needs to be given to the medical team which was one of the obstacles to end-of-life care. It is also necessary to decrease the heavy workload and increase the communication with medical workers.

Nurses’ Experiences of End-of-life Care in Long-term Care Hospitals in Japan: Balancing Improving the Quality of Life and Sustaining the Lives of Patients Dying at Hospitals

Ryo Odachi,Tomoko Tamaki,Mikiko Ito,TaTaketoshi Okita,Yuri Kitamura,Tomotaka Sobue 한국간호과학회 2017 Asian Nursing Research Vol.11 No.3

Purpose: In Japan, about 80% of deaths occur in hospitals, especially long-term care beds. The purpose of this study was to clarify the nursing practices used for such older patients at the end-of-life stage in longtermcare wards via the modified grounded theory approach (M-GTA). Methods: Data were obtained through semi-structured interviews of nineteen nurses working in cooperating long-term care wards, acute care wards, or hospice services (to allow for constant comparison between these types of wards) in western Japan in 2014. We analyzed the transcribed data using M-GTA. Results: The core category that emerged from the analysis was “Balancing enhancement of patients' daily life quality and life-sustaining care in the face of uncertainty about the patients' character.” Eleven categories emerged, such as Seeking older patients' character with their family, Supporting families' decision making, Rebuilding patients' daily life in the ward, and Sustaining patients' life span through medical care. Conclusions: Nurses experienced uncertainty about the care needs of older patients, the ethical problems of Enhancing the patients' QOL by using risky care, and the evaluation criteria used to judge their own nursing care after the patients' death. All nurses had the goal of ensuring a natural death for all patients. Nurses' acceptance and evaluation of their own care was critically influenced by the patient's family's responses to their care after patients' death. Further research is necessary to develop evaluation criteria and educational programs for end-of-life nursing care of older adults.