한국산학기술학회논문지 (Journal of the Korea Academia-Industrial cooperation Society)

  • 제17권9호
  • /
  • Pages.253-264
  • /
  • 2016
  • /
  • 1975-4701(pISSN)
  • /
  • 2288-4688(eISSN)
한국산학기술학회 (The Korea Academia-Industrial cooperation Society)
권호 표지
DOI QR코드

DOI QR Code

요양병원 간호사의 치매환자 통증관리 수행에 영향을 미치는 요인

Factors affecting nurse's pain management for patients with dementia

  • 투고 : 2016.08.05
  • 심사 : 2016.09.09
  • 발행 : 2016.09.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구는 요양병원 간호사의 치매환자 통증관리수행에 영향을 미치는 요인을 규명하기 위한 서술적 조사연구이다. 대상자는 B시 소재 30개 요양병원의 간호사 168명이며, 자료 수집기간은 2016년 6월 25일에서 7월 15일까지였다. 수집된 자료는 SPSS/WIN 22.0 통계 프로그램을 이용하여, 빈도와 백분율, t-test, ANOVA, Scheff's test, Pearson 상관계수, 다중회귀분석을 시행하였다. 연구 결과 대상자의 치매환자 통증에 대한 지식은 18점 만점에 10.73점으로 낮았으며, 통증관리태도는 평균 $2.98{\pm}0.27$점, 자기효능감은 평균 $3.34{\pm}0.61$점으로 중간보다 높았다, 장애요인은 평균 $2.90{\pm}0.51$점으로 중간 정도였으며, 통증관리수행은 평균 $4.09{\pm}0.52$점으로 높은 수준이었다. 대상자의 특성에 따른 통증관리수행 정도는 연령(p=.046), 요양병원경력(p=.009), 통증교육(p=.004)에 따라 유의한 차이가 있었다. 대상자의 통증지식, 태도, 자기효능감, 장애요인과 통증관리수행의 상관관계를 분석한 결과 태도(r=.21, p=.006), 자기효능감(r=.51, p<.001)과는 양의 상관, 장애요인(r=-.16, p=.035)과는 음의 상관관계를 보였다. 통증관리수행에 영향을 미치는 요인은 자기효능감, 요양병원경력, 통증교육 순이었고 전체 설명력은 30.1%이었다. 따라서 요양병원 간호사의 치매환자 통증관리수행을 높이기 위해서 정확한 통증지식과 자기효능감을 높일 수 있는 프로그램을 개발할 필요가 있다.

The aim of this study was to investigate the factors influencing nurses' pain management in patients with dementia. A total of 197 nurses were recruited from 30 long-term care hospitals in B city. Data were collected from June 25 to July 15, 2016. Data analysis was performed using the SPSS 22.0 program, which included a t-test, ANOVA, Scheffe test, Pearson's correlation, and multiple regression analyses. The levels of knowledge were low with a score of 10.73 out of 18. The level of attitudes, self-efficacy, barriers and performance were 2.98, 3.34, 2.90, and 4.09, respectively. In addition, there were significant differences in the level of performance depending on the age (p=.046), long-term care (p=.009), and pain education (p=.004). The level of attitudes (r=.21, p=.006), self-efficacy (r=.51, p<.001) and performance were positively correlated with each other. A significant negative correlation was observed between the barriers and performance (r=-.16, p=.035). The meaningful variables that influence the performance were self-efficacy, long-term care, and pain education. These factors were responsible for 30.1%. Therefore, effective programs will be necessary to enhance pain management by improving the self-efficacy and knowledge of pain in dementia patients.

키워드

참고문헌

  1. National Assembly Budget Office. Dementia reference information[Internet], [cited 2014]available from: http://www.nabo.go.kr/Sub/04Etc/04_Search.jsp (accessed May., 12, 2016)
  2. National Health Insurance Service. "Long-term care i nsurance statistics annual report", [cited 2015 Jul 30]available from http://www.nhis.or.kr/bbs7/boards/B0039/3115(accessed May., 12, 2016)
  3. E. Scherder, K. Herr, G. Pickering, S. Gibson, F. Benedetti, S. Lautenbacher, "Pain in dementia.", International Association for the study of Pain, 145(3), pp. 276-278, 2009. DOI: http://dx.doi.org/10.1016/j.pain.2009.04.007
  4. H. C. Bang, K. C. Park, M. H. Kim, Y. B. Lee, H. J. Roh, "Characteristics of Pain Threshold and Pain Experience in Elderly Patients with Dementia", Korean Psychosomatic Society, 21(2), pp. 140-146, 2013.
  5. K. Herr, K. Bjoro, S. Decke, "Tools for assessment of pain in nonverbal older adults with dementia: A state-of-the-science review", Journal of Pain Symptom Management, 31(2), pp. 170-192, 2006. DOI: http://dx.doi.org/10.1016/j.jpainsymman.2005.07.001
  6. J. Cohen-Mansfield, M. Creedon, "Nursing staff members' perceptions of pain indicators in persons with severe dementia", Clinical Journal of Pain, 18(1), pp. 64-73, 2002. DOI: http://dx.doi.org/10.1097/00002508-200201000-00010
  7. S. Kaasalainen, E. Coker, L. Dolovich, T. Hadjist avropoulous, A. Emili, J. Ploeg, "Pain management decision making among longterm care physicians and nurses", Western Journal of Nursing Research, 29(5), pp. 561-580, 2007. DOI: http://dx.doi.org/10.1177/0193945906295522
  8. K. R. Jones, R. Fink, G. Pepper, E. Hutt, C. P. Vojir, J. Scott, L. Clark, K. Mellis, "Improving Nursing Home Staff Knowledge and Attitudes about Pain", Gerontological Society of America, 44(4), pp. 469-478, 2004.
  9. M. Rantala, P. Kankkunen, T. Kvist, S. Hartikainen, "Barriers to Postoperative Pain Management in Hip Fracture Patients with Dementia as Evaluated by Nursing Staff", American Society for Pain Management Nursing, 15(1), pp. 208-219, 2014. DOI: http://dx.doi.org/10.1016/j.pmn.2012.08.007
  10. A. Kenefick, D. Schulman-Green, "Caring for cogniti vely impaired nursing home residents with pain", Int ernational Journal for Human Caring, 8(2), pp. 32-40, 2004.
  11. R. Chandler, B. Bruneau, "Barriers to the management of pain in dementia care", Nursing Times, 110(28), pp. 12-16, 2014.
  12. E. J. Kim, "Nurses' attitudes and perceptions of pain in patients with severe dementia", Clinical Nursing Research, 12(1), pp. 159-167, 2006.
  13. S. O. Jang, "Development and effect of pain management protocol for nursing home patients with dementia", Journal of Korean Academy of Nursing, 14(1), pp. 29-43, 2007.
  14. E. K. Kim, S. Y. Kim, M. R. Eom, H. S. Kim, E. P. Lee, "Validity and Reliability of the Korean Version of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate", Journal of Korean Academy of Nursing. 44(4), pp. 398-406, 2014. DOI: http://dx.doi.org/10.4040/jkan.2014.44.4.398
  15. E. N. Ryoo, K. S. Park, "Validity, reliability and efficiency of pain self report scale in elderly with dementia", Korean Journal of Adult Nursing, 23(2), pp. 111-122, 2011.
  16. Y. S. Ryu, J. M. Seo, "Nurses' Perception of Pain Management and its Performanace for Patients with Dementia", Global Health Nursing, 6(1), pp. 40-50, 2000.
  17. M. H. Lee, "Geriatric Hospital Nurses' Empathy, Attitude and Performance of Pain Management for Dementia Patients", College of Nursing Graduate School Chungnam National University, 2014.
  18. H. E. Barry, C. Parsons, A. P. Passmore, C. M. Hughes, "An exploration of nursing home managers' knowledge of and attitudes towards the management of pain in residents with dementia", International Journal of Geriatric Psychiatry, 27, pp. 1258-1266, 2012. DOI: http://dx.doi.org/10.1002/gps.3770
  19. R. Sloman, M. Ahern, A. W. MappSc, L. Brown, "Nurse's knowledge of pain in the elderly", Journal of Pain and Symptom Management, 21(4), pp. 317-322, 2001. https://doi.org/10.1016/S0885-3924(01)00248-2
  20. S. M. Zwakhalen, J. P. Hamers, R. H. Peijuenburg, M. P. Berger, "Nursing staff knowledge and beliefs about pain in elderly nursing home residents with dementia", Pain Research & Management, 12(3), pp. 177-184, 2007. DOI: http://dx.doi.org/10.1155/2007/518484
  21. American Geriatrics Society(AGS), "Panel on Persistent Pain in Older Person, Clinical guideline : The management of persistent pain in older persons", Journal of the American Geriatrics Society, pp. 205-224, 2009.
  22. Registered Nurses' Association of Ontario, "Nursing Best Practice Guideline Assessment Management of Pain", 2007.
  23. American Society Pain Management Nursing, "Pain Assessment in the Patient Unable to Self-Report", pp. 1-60, 2011.
  24. L. C. Chiang, H. J. Chen, L. Huang, "Student nurses' knowledge, attitudes, and self-efficacy of children's pain management: evaluation of an education program in Taiwan", Journal of pain symptom management, 32(1), pp. 82-89, 2006. DOI: http://dx.doi.org/10.1016/j.jpainsymman.2006.01.011
  25. H. R. Ryu, "Relationship among knowledge, self-effi cacy and nursing practice of nurses in the management of pediatric pain", College of Nursing Graduate School Seoul National University, 2014.
  26. J. H. Mun, "The comparison of Physician's and Nurse's Knowledge and Attitudes Toward Pain Management", College of Nursing Graduate School Kyungpook National University, 2014.
  27. S. H. Kim, S. Y. Park, "A University Hospital Nurses' Knowledge and Attitude about Cancer Pain Management", Journal of the Korea Academia Industrial cooperation Society, 13(1), pp. 254-263,2012. DOI: http://dx.doi.org/10.5762/KAIS.2012.13.1.254
  28. A. L. Han, S. H. Kwon, "Effects of Self-leadership and Self-efficacy on Nursing Performance of Nurses Working in Long-term Care Hospitals", Journal of Korean Gerontological Nursing, 18(1), pp. 12-21, 2016. DOI: http://dx.doi.org/10.17079/jkgn.2016.18.1.12
  29. E. K. Kim, M. H. Park, "Nurses' awareness and performance about evidence-based pain management in older adults", Korean Journal of Adult Nursing, 24(1), pp. 20-30, 2012. DOI: http://dx.doi.org/10.7475/kjan.2012.24.1.20
  30. J. N. Kim, Y. H. Kwon, "The relationship with the knowledge, attitude and nursing practice of the nurse-towards the elderly in geriatric hospitals", Keimyung Journal of Nursing Science, 13(1), pp. 39-50, 2009.
  31. I. S. Noh, J. A. Oh, "Factors Influencing Neonate Pain Management Performed by Nurses", J Korean Acad Child Health Nurs, 17(3), pp. 190-197, 2011. DOI: http://dx.doi.org/10.4094/jkachn.2011.17.3.190.
  32. E. J. Lee, S. O. Yang, "Clinical Knowledge and Actual Performance of Pressure Ulcer Care by Hospital Nurses", Journal of Korean Clinical Nursing Research, 17(2), pp. 251-261, 2011.