요양병원 간호사의 치매환자에 대한 신체 억제대 적용 관련 요인 = Factors related to the use of physical restraints for dementia patients in geriatric hospitals

다국어 초록 (Multilingual Abstract)

The purpose of this study is to conduct a descriptive study to understand the attitudes toward dementia, nursing professionalism, nursing ethics, knowledge of physical restraints, and nursing practice for the application of physical restraints to dementia patients of nurses who care for dementia patients in geriatric hospitals in order to find out factors related to nursing practice for the application of physical restraints.

Data were collected from 90 nurses who care for dementia patients at a nursing hospital located in C city from September 16 to September 26, 2020, using a structured questionnaire. The questionnaire was consisted of attitudes toward dementia, nursing professionalism, nursing ethics, knowledge and nursing practice for physical restraints. The the descriptive statistics of the collected data were analyzed according to the purpose of the study using SPSS/WIN 23.0. In addition, t-tests, ANOVAs, and correlation analyses were conducted, and regression analysis was carried out to find out the factors that affect the degree of nursing practice.

The results of this study are summarized as follows.
1) As for the general characteristics, the ratio of the nurses in the age group of 50s was the highest at 46.7%, and the ratio of the nurses with a service career of 1 to 5 years was the highest at 52.2%. As for the pattern of work, the ratio of shift work was high at 68.9%, and as for the time zone of application of physical restraints, night work accounted for 95.6%. As for whether the guidelines for the use of physical restraints were educated, 94.4% of the nurses answered “yes”, and as for the content of education on physical restraints wanted by the nurses, the ratio of the nurses who selected alternative methods was shown to be high at 36.7%.

2) Scores of the measurement tools
The score of the attitude toward dementia of nurses was 5.14 points out of the full score of 7 points. The score nursing professionalism was 3.77 points out of the full score of 5 points. The score of nursing ethics was 2.90 points out of the full score of 4 points. The percentage of correct answers to questions about the knowledge of the application of physical restraints was 71.9% for the full score of 22 points. The average score of the degree of nursing practice for the application of physical restraints was 2.74 points for the Likert 3-point scale. Given these results, all the scores for the measurement tools were shown to be at high levels.

3) The attitudes toward dementia, nursing professionalism, nursing ethics, knowledge of physical restraints, and nursing practice for the application of physical restraints of the nurses according to the general characteristics were analyzed. According to the results, the scores of nursing professionalism were significantly different among age group (=8.589, <.001), between those with religion and those without any religion (=3.741, <.001), and among the numbers of beds (=3.255, =.043) among general characteristics and the scores of the nursing ethics were significantly different between those with religion and those without any religion (=2.522, =.013) among general characteristics.

4) With regard to the correlations between the degree of nursing practice for the application of physical restraints and the attitudes toward dementia, nursing professionalism, nursing ethics, and knowledge of physical restraints, all the correlations were shown to be significant with =.259(=.014) for the attitudes toward dementia, =.334(=.001) for nursing professionalism, =.438(<.001) for nursing ethics, and =.344(=.001) for knowledge of physical restraints. Therefore, it can be said that the higher the attitude, professionalism, and ethics, and knowledge of physical restraints, the higher the degree of nursing practice.

5) Regression analyses were conducted to examine factors that affect nursing practice for the application of physical restraints. The regression model was found to be significant (=9.822, <.001) and that shows the explanatory power of the model was shown to be 0.284, indicating that the explanatory power of the model was 28.4%. The nursing ethics (=0.334, =.003) and knowledge (=0.323 =.001) were found to be factors that statistically significantly affect the degree of nursing practice.

In conclusion, this study found that the attitudes toward dementia, nursing professionalism, nursing ethics, knowledge of physical restraints, and nursing practice for the application of physical restraints to dementia patients of nurses who care for dementia patients in geriatric hospitals were significantly positively correlated with each other and that the factors related to the degree of nursing practice for the application of physical restraints were nursing ethics and knowledge. Therefore, in order to improve the degree of proper nursing practice for the application of physical restraints, continuous nursing ethics education through job training of nurses and education on the knowledge of physical restraints based on regulations and guidelines for the application of physical restraints are considered necessary.

목차 (Table of Contents)

• Ⅰ. 서론 1
• 1. 연구의 필요성 1
• 2. 연구의 목적 2
• 3. 용어의 정의 3
• Ⅱ. 문헌고찰 4
• 1. 치매에 대한 태도 4
• 2. 간호 전문직관 5
• 3. 윤리의식 5
• 4. 치매환자의 신체 억제대 적용 6
• Ⅲ. 연구방법 7
• 1. 연구설계 7
• 2. 연구대상 8
• 3. 연구도구 8
• 4. 자료수집 9
• 5. 윤리적 고려 10
• 6. 자료분석 10
• 7. 연구의 제한점 10
• Ⅳ. 연구결과 11
• 1. 일반적 특성 11
• 2. 치매에 대한 태도 12
• 3. 간호 전문직관 13
• 4. 윤리의식 15
• 5. 신체 억제대 적용에 대한 지식 16
• 6. 신체 억제대 적용에 대한 간호실무수행 정도 17
• 7. 일반적 특성에 따른 신체 억제대 적용에 대한 치매에 대한 태도, 간호 전문직관, 윤리의식, 신체 억제대 지식 및 간호실무수행 정도 18
• 8. 신체 억제대 적용에 대한 간호실무수행 정도와 각 항목간의 상관관계 21
• 9. 신체 억제대 적용에 대한 간호실무수행에 영향을 미치는 요인 21
• Ⅴ. 논의 22
• Ⅵ. 결론 및 제언 25
• 1. 결론 25
• 2. 제언 26
• 참고문헌 27
• ABSTRACT 30
• 부록 33