DOI QR코드

DOI QR Code

Nurses Attitudes toward Death, Coping with Death and Understanding and Performance Regarding EOL Care: Focus on Nurses at ED, ICU and Oncology Department

임종 다빈도 부서 간호사의 죽음에 대한 태도 및 대처정도와 생애 말기환자 간호와의 관계 - 응급실, 중환자실, 종양내과 병동 간호사를 중심으로

  • Seo, Min-Jeong (Hospice and Palliative Care Team) ;
  • Kim, Jung Yeon (Surgical Intensive Care Unit, Severance Hospital) ;
  • Kim, Sanghee (College of Nursing & The Nursing Policy Research Institute, Yonsei University) ;
  • Lee, Tae Wha (College of Nursing & The Nursing Policy Research Institute, Yonsei University)
  • 서민정 (세브란스병원 호스피스실) ;
  • 김정연 (세브란스병원 외과계 중환자실) ;
  • 김상희 (연세대학교 간호대학 연세대학교 간호정책연구소) ;
  • 이태화 (연세대학교 간호대학 연세대학교 간호정책연구소)
  • Received : 2013.03.07
  • Accepted : 2013.04.30
  • Published : 2013.06.01

Abstract

Purpose: The objectives of this study were to 1) explore nurses' attitudes toward death, coping with death, understanding and performance regarding end-of-life (EOL) care, 2) describe correlations among the above factors, and 3) determine the factors affecting nurses' EOL care performance. Methods: Study participants were 187 nurses stationed at departments that post higher mortality than others such as the oncology department, intensive care unit (ICU) and emergency department (ED). Data were collected from three urban university-affiliated hospitals. Multi-dimensional measure was performed for study instruments such as "attitude toward death", "coping with death" and "understanding and performance regarding EOL care". Data were analyzed by using descriptive statistics, correlation, and multiple regressions. Results: First, nurses showed significantly different attitudes toward death by age, religion, work unit and EOL care education. Younger nurses tend to score low on the understanding of EOL care, and ED nurses' score was lower than their peers at the oncology department and ICU. Second, EOL care performance was positively correlated with attitude toward death (P<0.001), coping with death (P=0.003) and understanding of EOL care (P<0.001). Third, nurses' EOL care performance was affected by work unit (P<0.001) and understanding of EOL care (P<0.001). Conclusion: Because nurses' performance was influenced by their work unit and understanding of EOL care, they should be provided with appropriate training to improve their understanding of death and EOL care according to work unit.

목적: 본 연구의 목적은 1) 죽음에 대한 태도와 대처정도, 생애 말기환자 간호인식 및 간호수행 정도를 파악하고, 2) 그들 간의 상관관계를 살펴보고, 3) 생애 말기환자 간호수행에 영향을 미치는 요인을 파악하고자 함이다. 방법: 3개 대학병원의 임종 다빈도 부서인 종양내과병동, 중환자실, 응급실에 근무하는 187명의 간호사를 대상으로 하였다. 연구 도구로는 '다차원 죽음에 대한 태도 척도', '죽음에 대한 대처정도 척도', '생애 말기환자 간호에 대한 인식 척도', '생애 말기환자 간호에 대한 수행 척도'를 사용하였다. 자료는 기술 통계, 상관관계, 다중 회귀분석을 수행하였다. 결과: 첫째, 생애 말기환자 간호수행은 결혼 유무, 종교, 근무 부서, 말기환자 간호에 대한 교육 참여 여부에 따라 의미 있는 차이를 보였다. 둘째, 생애 말기환자 간호수행은 죽음에 대한 태도(P=0.014), 죽음에 대한 대처(P=0.003), 생애 말기환자 간호인식(P<0.001)과 양의 상관관계를 보였다. 셋째, 생애 말기환자 간호수행이 근무부서(P<0.001), 생애 말기환자 간호인식(P<0.001)에 영향을 받는 것으로 나타났다. 결론: 생애 말기환자 간호수행이 근무 부서, 생애 말기환자 간호인식에 영향을 받으므로, 근무 부서에 따라 차별화된 생애 말기환자 간호인식을 향상시킬 수 있는 교육이 필요하다.

Keywords

References

  1. Korea National Statistical Office. 2009 Annual report on the cause of death statistics [Internet]. Seoul: Korea National Statistical Office; 2010. [cited 2013 Mar 14]. Available from: http:// meta.kosis.kr/bzmt/main.jsp.
  2. Jeon MH. Recognition among nurses and doctors about the death in ER & ICU [master's thesis]. Seoul: Hanyang Univ.; 2008. Korean.
  3. Lee YS, Tae YS. The lived experience of the burnout of nurses working in oncology wards. Asian Oncol Nurs 2012;12:100-109. https://doi.org/10.5388/aon.2012.12.1.100
  4. Lee YO. A study of cancer unit nurses' stress from bereavement support [master's thesis]. Seoul: Kyung Hee Univ.; 2004. Korean.
  5. Sheward K, Clark J, Marshall B, Allan S. Staff perceptions of end-of-life care in the acute care setting: a New Zealand perspective. J Palliat Med 2011;14:623-30. https://doi.org/10.1089/jpm.2010.0470
  6. Braun M, Gordon D, Uziely B. Associations between oncology nurses' attitudes toward death and caring for dying patients. Oncol Nurs Forum 2010;37:E43-E49. https://doi.org/10.1188/10.ONF.E43-E49
  7. Noh SS. A study on death perception, terminal care attitude, and terminal care performance of clinical nurses caring for cancer patients [master's thesis]. Seoul: Sungkyunkwan Univ.; 2010. Korean.
  8. Wong PTP, Recker GT, Gesser G. Death attitude profile-revised: a multidimensional measure of attitudes toward death. In: Neimeyer RA, ed. Death anxiety handbook: reserch, instrumentation, and application. Washington, DC:Tayler & Francis;1994. p. 121-48.
  9. Lee UY. Validation of Wong's death attitude profile-revised [master's thesis]. Daejeon: Chungnam National Univ.; 2008. Korean.
  10. Bugen LA. Coping: effects of death education. Omega: J Death Dying 1980-81;11:175-183.
  11. Kim JH. Predictors of death fear, death acceptance and death competency across the adult life span [dissertation]. Seoul: Seoul Univ.; 2008. Korean.
  12. Robbin RA. Death competency: Burgen's coping with death scale and death self- efficacy. In: Neimeyer RA, ed. Death anxiety handbook: reserch, instrumentation, and application. Washington, DC:Tayler & Francis;1994. p. 149-179.
  13. Bae YR. The degree of clinical nurses' perception of hospice care and their performance and the degree of hospice patients' expectation and satisfaction [master's thesis]. Seoul: Ewha Womans Univ.; 2000. Korean.
  14. Research ethics policy [Internet]. Seoul: The Korean Association for Survey Research; c1999-2007. [cited 2011 Oct 12]. Available from: http://www.kasr.org.
  15. Yi M. Nurses' experience of caring for dying patients in hospitals. J Korean Acad Nurs 2003;33:553-561. https://doi.org/10.4040/jkan.2003.33.5.553
  16. Kim SE. The relationship between Intensive care unit nurses' death perception and terminal care performance [master's thesis]. Suwon: Ajou Univ.; 2011. Korean.
  17. Cho YC. Emergency nurses' perception of death and terminal care attitude [master's thesis]. Suwon: Ajou Univ.; 2011. Korean.
  18. Kim JH, Lee HK. Cancer unit nurses' end-of-life care-related stress, understanding and training needs. Korean J Hosp Palliat Care 2012;15:205-11.
  19. Zhou G, Stoltzfus JC, Houldin AD, Parks SM, Swan BA. Knowledge, attitudes, and practice behaviors of oncology advanced practice nurses regarding advanced care planning for patients with cancer. Oncol Nurs Forum 2010;37:E400-E410. https://doi.org/10.1188/10.ONF.E400-E410
  20. Jo KH, Kim YJ, Sohn KC. Types of perception toward end-oflife medical decision-making of clinical nurses: Q-methodological approach. Korean J Hosp Palliat Care 2012;15:18-29.
  21. Crump SK, Schaffer MA, Schulte E. Critical care nurses' perceptions of obstacles, supports, and knowledge needed in providing quality end-of-life care. Dimens Crit Care Nurs 2010;29:297-306. https://doi.org/10.1097/DCC.0b013e3181f0c43c

Cited by

  1. Death Perceptions, Death Anxiety, and Attitudes to Death in Oncology Nurses vol.13, pp.4, 2013, https://doi.org/10.5388/aon.2013.13.4.265
  2. Awareness of Good Death and Attitudes toward Terminal Care among Geriatric Hospital Nurses vol.17, pp.3, 2014, https://doi.org/10.14475/kjhpc.2014.17.3.122
  3. Nurses' Spirituality and Attitude toward Terminal Care in Geriatric Hospital vol.13, pp.12, 2015, https://doi.org/10.14400/JDC.2015.13.12.347
  4. Pediatric Nurses' Perception and Knowledge about Pediatric Hospice Palliative Care vol.18, pp.3, 2015, https://doi.org/10.14475/kjhpc.2015.18.3.235
  5. Factors Related to Emergency Department Healthcare Providers' Attitudes towards End-of-Life Care vol.19, pp.1, 2016, https://doi.org/10.14475/kjhpc.2016.19.1.11
  6. Development of Audio-visual Aids of Death Education for Hospice Patients and Their Families vol.19, pp.3, 2016, https://doi.org/10.14475/kjhpc.2016.19.3.240
  7. Factors Influencing Performance of End-of-life Care by ICU Nurses vol.25, pp.4, 2016, https://doi.org/10.12934/jkpmhn.2016.25.4.327
  8. Changes of Nursing Activities on Patients with DNR Orders vol.20, pp.1, 2017, https://doi.org/10.14475/kjhpc.2017.20.1.46
  9. Mediating Effects of Empathy and Resilience on the Relationship between Terminal Care Stress and Performance for Nurses in a Tertiary Hospital vol.20, pp.4, 2017, https://doi.org/10.14475/kjhpc.2017.20.4.253
  10. Correlates of perceived death competence: What role does meaning-in-life and quality-of-life play? pp.1478-9523, 2019, https://doi.org/10.1017/S1478951518000937
  11. Influence of Perceptions of Death, End-of-Life Care Stress, and Emotional Intelligence on Attitudes towards End-of-Life Care among Nurses in the Neonatal Intensive Care Unit vol.25, pp.1, 2019, https://doi.org/10.4094/chnr.2019.25.1.38
  12. 신생아중환자실 간호사의 완화간호에 대한 지식과 태도 및 죽음에 대한 인식 간의 관계 vol.22, pp.4, 2013, https://doi.org/10.4094/chnr.2016.22.4.257
  13. 호스피스 관련 국내 간호연구 논문 동향(1998~2017) vol.22, pp.1, 2013, https://doi.org/10.14475/kjhpc.2019.22.1.19
  14. 신규간호사의 죽음불안, 임종간호 스트레스가 직무만족도에 미치는 영향 vol.28, pp.4, 2013, https://doi.org/10.5807/kjohn.2019.28.4.230
  15. Validation of the Nurses' Involvement in Dying Patients and Family Care-Korean Version vol.23, pp.4, 2013, https://doi.org/10.14475/kjhpc.2020.23.4.228
  16. A Mixed Method Study for Exploring the Difficulties in End-of-Life Care and End-of-Life Care Competency in Nurses Who Take Care of Cancer Patients vol.21, pp.2, 2013, https://doi.org/10.5388/aon.2021.21.2.98
  17. End-of-Life Care Mobile App for Intensive-Care Unit Nurses: A Quasi-Experimental Study vol.18, pp.3, 2021, https://doi.org/10.3390/ijerph18031253
  18. 임상간호사의 임종간호수행 구조모형 vol.14, pp.1, 2021, https://doi.org/10.34250/jkccn.2021.14.1.1
  19. 중환자실 간호사의 생애말 간호수행에 미치는 영향요인 vol.7, pp.3, 2021, https://doi.org/10.17703/jcct.2020.7.3.135