DOI QR코드

DOI QR Code

Nursing Practice Environment and Moral Distress Impact on Person-centered Care of Long-term Care Hospital Nurses

요양병원 간호사의 간호근무환경, 도덕적 고뇌가 인간중심돌봄에 미치는 영향

  • Received : 2020.11.04
  • Accepted : 2020.12.30
  • Published : 2020.12.31

Abstract

This study was conducted to evaluate the nursing practice environment, moral distress, and the factors that influence person-centered care and the experience of person-centered care among nurses working in a long-term care hospitals. 154 nurses who was working in long-term care hospitals in D city and G province were evaluated. Date were collected from May 1st to 31th, 2020 and analyzed using the SPSS/WIN 25.0 program. The mean score of nursing practice environment was 2.42, the moral distress was 3.27, and person-centered care was 3.60. Person-centered care showed significantly positive correlations with moral distress(r=.53, p<.001) and showed significantly positive correlations with nursing practice environment(r=.32, p<.001). Regression analysis revealed that the factors which significantly influenced person-centered care were nursing practice environment and moral distress. Therefore, in order to increase person-centered care, nursing intervention programs that improve the nursing practice environment and reduce moral disgtress are required for nurses working in long-term care hospitals.

본 연구는 요양병원 간호사의 간호근무환경, 도덕적 고뇌가 인간중심돌봄의 관계를 확인하고, 인간중심돌봄에 미치는 영향을 파악하기 위한 서술적 조사연구이다. D시와 G도 소재 요양병원에서 현재 근무하는 간호사를 대상으로 시행되었다. 자료수집은 2020년 5월 1일부터 31일까지로 총 154명을 SPSS 25.0로 분석하였다. 간호근무환경은 2.42점, 도덕적 고뇌는 3.27점, 인간중심돌봄은 3.60점이었다. 인간중심돌봄의 영향요인은 간호근무환경, 도덕적 고뇌로 나타났다. 이는 요양병원 간호사의 인간중심돌봄을 증진시키기 위한 방안으로 관리자들의 지속적인 관심으로 요양병원 간호사의 근무환경 개선과 도덕적 고뇌의 감소를 위한 실질적인 방안 마련이 필요해 보인다.

Keywords

References

  1. Statistic Korea. (2019). http://kostat.go.kr/portal/korea/index.action
  2. K. J. Kwon, T. J. Park, S. Y. Lee. (2014). A survey on elderly human rights of geriatric hospitals. Research Service Report. Seoul: National Human Rights Commission of Korea; Nov. Report No. 11-1620000-000571-01.
  3. S. Morgan, L. H. Yoder, "A concept analysis of person-centered care". Journal of Holistic Nursing, Vol.30 No.1 pp. 6-15, (2012). https://doi.org/10.1177/0898010111412189
  4. S. Brownie, S. Nancarrow, "Effects of person-centered care on residents and staff in aged-care facilities a systematic review", Vol.8, pp.1-10, (2013).
  5. L. Lorenzo-Lopez, C. de Labra, A. Maseda, T Lorenzo, H. Agrafojo, J. Luis-Rodriguez-Villamil, L. Gonzalez-Abralades, J. C. Millan-Calenti, "Caregiver's distress related to the patient's neuropsychiatric symptoms as a function of the care-setting", Geriatric Nursing, Vol.38, No.2 pp. 110-118, (2017). https://doi.org/10.1016/j.gerinurse.2016.08.004
  6. Health Insurance Review & Assessment Service.[Internet]. Press release. Results of Evaluation of Long Term Care Hospitals, 2010: 2011 Sep 30 [updated 2011 Sep 30; cited 2015 Dec 10] Available from: http://www.hira.or.kr/bbsDummy.do?pgmid=HIRAA020041000100&brdScnBltNo=4&brdBltNo=8197
  7. M. R. Sim, K. H. Kim, "Job satisfation, self-esteem. and nursing task performance among registered nurses and nurses and nurse assistants in long-term care hospitals", Journal of Korean Academy of Nursing, Vol.16, No.4 pp. 446-454, (2010). https://doi.org/10.11111/jkana.2010.16.4.446
  8. Korea Institute for Healthcare Accreditation, 3 cycle long-term care hospital certification criteria, 2019
  9. S. S. Kim, The Experiences in Long-term Care Hospital as a Nurse, Unpublished doctoral dissertation, Donga university, Busan, (2013).
  10. J. B. Hessler, M. Schaufele, I. Hendlmeier, M. N. Junge, S. Leonhardt, J. Weber, H. Bickel, "Behavioural and psychological symptoms in general hospital patients with dementia, distress for nursing staff and complications in care: results of the General Hospital Study", Epidemiol Psychiatr Sciences, Vol.27, No.3 pp. 278-287, (2018). https://doi.org/10.1017/S2045796016001098
  11. I. S. Sohn, H. S. Kim, J. S. Kwon, D. L. Park, Y. H. Han, S. S. Han, "Development of an instrument to measure organizational socialization of new clinical nurses.", Journal of Korean Clinical Nursing Research, Vol.14, No.1 pp. 85-97, (2008).
  12. A. B. Hamric, C. T. Borchers, E. G. Epstein, "Development and testing of an instrument to measure moral distress in healthcare professionals", AJOB Primary Research, Vol.3, No.2 pp. 1-9, (2012). https://doi.org/10.1080/21507716.2011.652337
  13. A, Jameton, "Dilemmas of moral distress: Moral responsibility and nursing practice", AWHONN's Clinical Issues in Perinatal & Women's Health Nursing, Vol.4, No.4 pp. 542-551,(1993).
  14. Y. Chae, S. J. Yu, E. J., Lee, K. J. Kang, M. S. Park, M. Yu, "Validity and reliability of the Korean version of the moral distress scale-revised for Korean hospital nurses", The Journal of Korean Academic Society of Nursing Education, Vol.22, No.2 pp. 228-239, (2016). https://doi.org/10.5977/jkasne.2016.22.2.228
  15. E. T. Lake, "Development of the practice environment scale of the nursing work index", Research in Nursing & Health, Vol.25, No.3 pp. 176-88, (2002). https://doi.org/10.1002/nur.10032
  16. E. H. Cho, M. N. Choi, E.Y. Kim, I.Y. Yoo, N. J. Lee, "Construct validity and reliability of the Korean version of the practice environment scale of nursing work index for Korean nurses", Journal of Korean Academy of Nursing Administration, Vol.41, No.3 pp. 325-332, (2011). https://doi.org/10.4040/jkan.2011.41.3.325
  17. D. Edvardsson, D. Fetherstonhaugh, R. Nay, S. Gibson, "Development and initial testing of the Person-centered Care Assessment Tool(PCAT)". International Psychogeriatrics, Vol.22, No.1 pp. 101-108, (2010). https://doi.org/10.1017/S1041610209990688
  18. Y. R. Tak, H. Y. You, J. H. Kim, "Validity and reliability of the person centered care assessment tool in long-term care facilities in Korea". Journal of Korean Academy of Nursing, Vol.45, No.3 pp. 412-419, (2015). https://doi.org/10.4040/jkan.2015.45.3.412
  19. Y. Chae, S. J. Yu, E. J. Lee, E. H. Park, "The relation among moral distress, physical symptoms and burnout of hospital nurses", The Journal of Korean Academic Society of Nursing Education, Vol.23, No.4 pp. 430-440, (2017). https://doi.org/10.5977/jkasne.2017.23.4.430
  20. H. S. Kim, S. E. Yu, K. C. Lim, "Influencing factors on moral distress in long-term care hospital and facility nurses", Journal of The Korea Society of Computer and Information, Vol.24, No.5 pp.121-130, (2019). https://doi.org/10.9708/JKSCI.2019.24.05.121
  21. S. Y. Lee, & J.A. Kim, "A study of comparison of moral distress and burnout between long-term care hospital nurses and general hospital nurses", Journal of East-West Nursing Research, Vol.26, No.1 pp. 63-70, (2020). https://doi.org/10.14370/JEWNR.2020.26.1.63
  22. H. S. Joo, W. H. Jun, "Influence of nurses' work environment, organizational commitment, and nursing professionalism on turnover intention of nurses in long term care hospitals", Journal Korean Academic Nursing Adm, Vol.24, No.4 pp. 265-275. (2018). https://doi.org/10.11111/jkana.2018.24.4.265
  23. E. J. Choi, J. Y. Hwang, I. S. Jang, "Effects of nursing practice environmrnt and self-esteem on critical thinking disposition among clinical nurses", Journal academic Nursing Adm, Vol.23, No.2 pp. 161-169, (2017).
  24. E. M. Park, The influence of moral sensitivity and nursing poractice environment on person-centered care in long-term care hospital nurses. Unpublished master's thesis, Daegu Catholic University, Daegu.(2017).
  25. T. Martinez, J. Suarez-Alvarez, J. Yanguas, J. Muniz, "The person centered approach in gerontology: new validity evidence of the staff assessment", International Journal of Clinical and Health Psychology. Vol.16, No.2 pp. 175-185, (2016). https://doi.org/10.1016/j.ijchp.2015.12.001
  26. R. Y. Kang, Job satisfaction, turnover intention, and nursing work environment in nurses in small-medium sized hospitals categorized by number of beds. Unpublished master's thesis, Ewha Womans University, Seoul.(2018).
  27. E. M. Park, N.H. Park, "Influence of moral sensitivity and nursing practice environment in person-centered care in long-term care hospital nurses", Journal Korean Gerontol Nursing, Vol.20, No.2 pp. 109-118,(2018). https://doi.org/10.17079/jkgn.2018.20.2.109
  28. J. A. Kim, Y. S. Kang, "Moral distress and moral sensitivity of nurses working in long term care hospitals", Journal of the Korea Academia-Industrial cooperation Society, Vol.19, No.6 pp. 240-251, (2018). https://doi.org/10.5762/KAIS.2018.19.6.240
  29. R. J. Jang, The relationships between emotional intelligence, job satisfaction, and quality of nursing service in hospital nurses, Unpublished master's thesis, Gyeongsang National University, Jinju, (2015).
  30. S. B. Kim, Y. R. Park, "Factors associated with person-centered care for elderly in long-term care hospital nurses", Korea Journal of Adult Nursing, Vol.31, No.6 pp. 618-617,(2019). https://doi.org/10.7475/kjan.2019.31.6.618
  31. S. R. Jung. Factors affecting person-centered care among nurses working in long-term care hospitals, Unpublished master's thesis, Dong-Eui University, Busan, (2018).