Child Health Nursing Research

Korean Academy of Child Health Nursing (한국아동간호학회)
권호 표지
DOI QR코드

DOI QR Code

Neonatal Intensive Care Unit Nurses' Experience in Caring for Infants Who Are Dying

신생아중환자실 간호사의 임종 환아 돌봄 경험

  • Kang, Hyun-Ju (College of Nursing, Seoul National University) ;
  • Bang, Kyung-Sook (College of Nursing & The Research Institute of Nursing Science, Seoul National University)
  • 강현주 (서울대학교 간호대학) ;
  • 방경숙 (서울대학교 간호대학.간호과학연구소)
  • Received : 2013.05.26
  • Accepted : 2013.09.03
  • Published : 2013.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this phenomenological study was to explore neonatal intensive care unit (NICU) nurses' experience in caring for infants who are approaching death and to identity the meaning and structure of their experiences. Methods: The participants were eight nurses who had experience in caring for these infants. In-depth interviews were performed from December, 2012 to February, 2013 until data were fully saturated. Collected data were analyzed using Colaizzi's method. Results: Four theme clusters were extracted from fifteen themes. The four theme clusters of the NICU nurses' experience in caring for infants who are dying were: 1) Crossroads between life and comfort of infants approaching death, 2) emotional suffering at the death of the infant, 3) adapting and coping with the death of the infant, 4) new expectations for caring for infants who are dying. Conclusion: The results of the study provide useful information in understanding NICU nurses' experience in caring for infants who are dying and establishing effective strategies to support these nurses.

목적 본 연구의 목적은 신생아중환자실에서 근무하는 간호사의 임종 환아 돌봄 경험을 이해하고 개인의 생생한 경험의 전체적인 의미 구조를 기술하기 위함이다. 방법 본 연구는 현상학적 방법론을 적용한 질적 연구이다. 본 연구의 참여자는 서울시 S대학병원의 신생아중환자실에서 근무하면서 임종 환아 돌봄 경험이 있는 간호사로서 눈덩이 표집 방법을 통해 모집되었으며 자료가 충분히 포화되었다고 판단되는 시점까지로 정하여 총 8인이 선정되었다. 본 연구의 자료는 2012년 12월부터 2013년 2월까지 참여자와의 개인 심층 면담을 통하여 수집되었으며 수집된 자료는 Colaizzi의 현상학적 연구 방법을 근거로 분석되었다. 결과 신생아중환자실 간호사의 임종 환아 돌봄 경험의 구조는 '사투하는 환아의 생명존중과 안위존중의 갈림길', '환아의 죽음에 대한 정서적 고통', '환아의 죽음에 대처하며 적응하기', '임종 환아 돌봄에 대한 새로운 기대'의 4개의 주제모음으로 확인되었다. 결론 본 질적 연구를 통하여 신생아중환자실 간호사의 임종 환아 돌봄 경험을 좀 더 깊이 있게 살펴보고 이해할 수 있었다. 본 연구 결과를 토대로 신생아중환자실에 근무하면서 환아의 임종을 경험하는 간호사들이 느끼는 정서적인 갈등과 어려움을 다루고 지지해 줄 수 있는 전문적인 지지 프로그램의 개발과 임종 환아 돌봄에 대한 교육의 활성화와 더불어 임종 환아의 부모와 의료인을 위한 시간과 공간이 제도적으로 마련되었으면 한다.

Keywords

References

  1. Boyle, D. A. (2006). Desperate nursewives. Oncology Nursing Forum, 33(1), 11. Doi: 10.1188/06. ONF.11
  2. Bush, N. J., & Boyle, D. A. (2012). Self-healing through reflection: A workbook for nurses (1st ed.). Pittsburgh: Oncology Nursing Society.
  3. Catlin, A. (2004). Neonatal end-of-life care. The American Journal of Nursing, 104(8), 15. https://doi.org/10.1097/00000446-200401000-00007
  4. Choi, J. S., & Lee, N. H. (2011). Policy issues on birth outcomes from shifting trends in childbearing. Seoul: Korea Institute for Health and Social Affairs.
  5. Colaizzi, P. F. (1978). Psychological research as the phenomenologist views it. In R. S. Valle & M. King (Eds.), Existential phenomenological alternatives for psychology (pp. 48-71). New York: Oxford University Press.
  6. Dessy, E. (2009). Effective communication in difficult situation: Preventing stress and burnout in the NICU. Early Human Development, 85(10), S39-S41. https://doi.org/10.1016/j.earlhumdev.2009.08.012
  7. Doka, K. J. (2002). Disenfranchised grief: New directions, challenges, and strategies for practice (1st ed.). Champaign, IL: Research Press
  8. Kain, V. J. (2007). Moral distress and providing care to dying babies in neonatal nursing. International Journal of Palliative Nursing, 13(5), 243-248. https://doi.org/10.12968/ijpn.2007.13.5.23495
  9. Kang, B. H., Jung, K. A., Hahn, W. H., Shim, K. S., Chang, J. Y., & Bae, C. W. (2011). Regional analysis on the incidence of preterm and low birth weight infant and the current situation on the neonatal intensive care units in Korea, 2009. Journal of the Korean Society of Neonatology, 18(1), 70-75. https://doi.org/10.5385/jksn.2011.18.1.70
  10. Kang, K. A., & Kim, S. J. (2003). The present and future of children′s hospice care in Korea. Korean Journal of Child Health Nursing, 9(2), 190-197.
  11. Kang, S. Y. (2001). The lived experience of nursing care for the dying patients in clinical nurses. The Journal of Korean Nursing Administration Academic Society, 7(2), 237-251.
  12. Keene, E. A., Hutton, N., Hall, B., & Rushton, C. (2010). Bereavement debriefing sessions: an intervention to support health care professionals in managing their grief after the death of a patient. Pediatric Nursing, 36(4), 185-189.
  13. Kong, B. H. (2004). Phenomenology in nursing research. Research in Philosophy and Phenomenology, 23, 151-178.
  14. Kubler-Ross, E. (1969). On death and dying. New York, NY: Macmilan.
  15. Lenart, S. B., Bauer, C. G., Brighton, D. D., Johnson, J. J., & Stringer, T. M. (1998). Grief support for nursing staff in the ICU. Journal of Nurses in Staff Development, 14(6), 293-296. https://doi.org/10.1097/00124645-199811000-00008
  16. Omery, A. (1983). Phenomenology: A method for nursing research. Advances in Nursing Science, 5(2), 49-63. https://doi.org/10.1097/00012272-198301000-00010
  17. Rushton, C. H., Reder, E., Hall, B., Comello, K., Sellers, D. E., & Hutton, N. (2006). Interdisciplinary interventions to improve pediatric palliative care and reduce health care professional suffering. Journal of Palliative Medicine, 9(4), 922-933. https://doi.org/10.1089/jpm.2006.9.922
  18. Sandelowski, M. (1986). The problem of rigor in qualitative research. Advances in Nursing Science, 8(3), 27-37. https://doi.org/10.1097/00012272-198604000-00005
  19. Statistics Korea. (2011, June 29). Birth data of infant mortality (2005-2009). Retrieved December 4, 2012, from http://kostat.go.kr/portal/korea/ kor_nw/2/6/1/index.board?bmode=read&aSeq=248859
  20. Sherman, D. W. (2004). Nurses' stress and burnout: How to care for yourself when caring for patients and their families experiencing lifethreatening illness. American Journal of Nursing, 104(5), 48-56.
  21. Shimoinaba, K., O'Connor, M., Lee, S., & Greaves, J. (2009). Staff grief and support system for Japaneses health care professional working in palliative care. Palliative and Supportive Care, 7(2), 245-252. https://doi.org/10.1017/S1478951509000315
  22. Wakefield, A. (2000). Nurses' responses to death and dying: A need for relentless self-care. International Journal of Palliative Nursing, 6(5), 245-251. https://doi.org/10.12968/ijpn.2000.6.5.8926
  23. Yam, B. M., Rossiter, J. C., & Cheung, K. Y. (2001). Caring for dying infants: Experience of neonatal intensive care nurse in Hong Kong. Journal of Clinical Nursing, 10(5), 651-659. https://doi.org/10.1046/j.1365-2702.2001.00532.x
  24. Yi, M. S. (2003). Nurses' experience of caring for dying patients in hospitals. Journal of Korean Academy of Nursing, 33(5), 553-561.
  25. Yu, M. (2011). Work stress, turnover intention and burnout among nurses in neonatal intensive care units. Journal of Korean Academy of Nursing Administration, 17(1), 115-126. https://doi.org/10.11111/jkana.2011.17.1.115

Cited by

  1. Hospice Palliative Nurses' Experience of Caring for Terminal Cancer Patients vol.15, pp.4, 2015, https://doi.org/10.5388/aon.2015.15.4.264
  2. 간호사의 환자죽음 수용에 대한 개념분석 vol.19, pp.1, 2016, https://doi.org/10.14475/kjhpc.2016.19.1.34
  3. 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
  4. 중년기 아이돌보미 여성의 돌봄활동 경험 vol.24, pp.1, 2017, https://doi.org/10.22705/jkashcn.2017.24.1.023
  5. 간호사의 연명치료중단아동 돌봄경험 vol.23, pp.3, 2013, https://doi.org/10.4094/chnr.2017.23.3.364
  6. 분만장 간호사의 사산아와 부모 돌봄 경험 vol.23, pp.3, 2013, https://doi.org/10.4069/kjwhn.2017.23.3.166
  7. 신생아집중치료실 간호사의 임종간호 스트레스, 대처방식 및 심리적 안녕감 vol.24, pp.4, 2018, https://doi.org/10.4094/chnr.2018.24.4.475
  8. 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
  9. Neonatal ICU Nurses’ Coping with Death of High Risk Newborn vol.44, pp.2, 2013, https://doi.org/10.21032/jhis.2019.44.2.103
  10. 중환자실 간호사의 임종간호 어려움과 임종간호 교육요구 조사: 혼합연구방법 vol.22, pp.2, 2013, https://doi.org/10.14475/kjhpc.2019.22.2.87
  11. 중환자실 간호사가 경험한 사람-중심의 관계 돌봄에 대한 해석 현상학적 분석 연구 vol.49, pp.4, 2013, https://doi.org/10.4040/jkan.2019.49.4.423
  12. 요양병원 간호사의 노인 환자 임종간호 경험 vol.31, pp.2, 2020, https://doi.org/10.12799/jkachn.2020.31.2.199