한국간호교육학회지 (The Journal of Korean Academic Society of Nursing Education)

  • 제26권2호
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  • Pages.176-184
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  • 2020
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  • 1225-9578(pISSN)
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  • 2093-7814(eISSN)
한국간호교육학회 (The Korean Academic Society of Nursing Education)
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응급실 간호사의 도덕적 고뇌 대응 경험

Emergency nurses' experience of coping with moral distress

  • 투고 : 2019.12.06
  • 심사 : 2020.05.09
  • 발행 : 2020.05.31
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초록

Purpose: We explored emergency nurses' experiences of coping with moral distress. Methods: A qualitative research design was used. We conducted in-depth interviews with 11 nurses working at a regional emergency medical center in South Korea. Data were analyzed using conventional content analysis. Results: The main theme of nurses' coping with moral distress was "a passive emotion-based response." We also extracted three categories of coping strategies: "uncritical adaptation to anguished situation," "self-justification for not acting," and "flight from ethical decision making." Conclusion: Nurses coped with moral distress in a passive and emotional way, possibly because of perceived incompetence and compliance to an organizational hierarchy. The findings imply that effective approaches to addressing moral distress in emergency nurses are needed at the individual and organizational levels.

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참고문헌

  1. Bartram, T., Joiner, T. A., & Stanton, P. (2014). Factors affecting the job stress and job satisfaction of Australian nurses: Implications for recruitment and retention. Contemporary Nurse, 17(3), 293-304. https://doi.org/10.5172/conu.17.3.293
  2. Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56(2), 267-283. https://doi.org/10.1037//0022-3514.56.2.267
  3. Chae, Y., Yu, S., Lee, E. J., & Park, E. H. (2017). The relation among moral distress, physical symptoms and burnout of hospital nurses. Journal of Korean Academic Society of Nursing Education, 23(4), 430-440. https://doi.org/10.5977/jkasne.2017.23.4.430
  4. Chang, E. M., Hancock, K. M., Johnson, A., Daly, J., & Jackson, D. (2005). Role stress in nurses: Review of related factors and strategies for moving forward. Nursing and Health Sciences, 7(1), 57-65. https://doi.org/10.1111/j.1442-2018.2005.00221.x
  5. Choe, K., Lee, K. S., & Ham, M.-Y. (2012). Nurses' ethical difficulties in emergency department. Korean Journal of Medical Ethics, 15(2), 219-230. https://doi.org/10.35301/ksme.2012.15.2.219
  6. Epstein, E. G., & Hamric, A. B. (2009). Moral distress, moral residue, and the crescendo effect. Journal of Clinical Ethics, 20(4), 330-342.
  7. Epstein, E. G., Whitehead, P. B., Prompahakul, C., Thacker, L. R., & Hamric, A. B. (2019). Enhancing understanding of moral distress: The measure of moral distress for health care professionals. AJOB Empirical Bioethics, 10(2), 113-124. https://doi.org/10.1080/23294515.2019.1586008
  8. Farrell, G. A., Bobrowski, C., & Bobrowski, P. (2006). Scoping workplace aggression in nursing: findings from an Australian study. Journal of Advanced Nursing, 55(6), 778-787. https://doi.org/10.1111/j.1365-2648.2006.03956.x
  9. Folkman, S., & Lazarus, R. S. (1980). An analysis of coping in a middle-aged community sample. Journal of Health and Social Behavior, 21(3), 219-239. https://dx.doi.org/10.2307/2136617
  10. Haidt, J. (2001). The emotional dog and its rational tail: A social intuitionist approach to moral judgement. Psychological Review, 108(4), 814-834. https://doi.org/10.1037/0033-295X.108.4.814
  11. Hennink, M. M., Kaiser, B. N., & Marconi, V. C. (2017). Code saturation versus meaning saturation: how many interviews are enough? Qualitative Health Research, 27(4), 591-608. https://doi.org/10.1177/1049732316665344
  12. Hsieh, H.-F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277-1288. https://doi.org/10.1177/1049732305276687
  13. Jalali, K., Tabari-Khomeiran, R., Asgari, F., Sedghi-Sabet, M., & Kazemnejad, E. (2019). Moral distress and related factors among emergency department nurses. Eurasian Journal of Emergency Medicine, 18(1), 23-27. https://doi.org/10.4274/eajem.galenos.2018.78941
  14. Jameton, A. (1993). Dilemmas of moral distress: Moral responsibility and nursing practice. AWHONN’s Clinical Issues in Perinatal and Women’s Health Nursing, 4(4), 542-551.
  15. Jeon, K. B., & Park, M. (2019). Relationship of ICU nurses' difficulties in end-of-life care to moral distress, burnout and job satisfaction. The Journal of Korean Nursing Administration Academic Society, 25(1), 42-51. https://doi.org/10.11111/jkana.2019.25.1.42
  16. Jeon, Y., Kim, Y., & Son, H. (2019). Ethical climate and moral distress among neonatal intensive care unit RNs. Global Health & Nursing, 9(1), 28-37. https://doi.org/10.35144/ghn.2019.9.1.28
  17. Kim, H. S., Yu, S., & Lim, K. C. (2019). Influencing factors on moral distress in long-term care hospital and facility nurses. Journal of the Korea Society of Computer and Information, 24(5), 121-130. https://doi.org/10.9708/jksci.2019.24.05.121
  18. Kwon, S. B., Ahn, H. Y., Kwak, M. H., & Yun, S. H. (2019). Conflicts experienced by the nurses in hospital nursing organizations. Journal of Korean Academy of Nursing Administration, 25(5), 499-509. https://doi.org/10.11111/jkana.2019.25.5.499
  19. Lee, H. K., & Shin, J. S. (2012). Relationships among ethical dilemma experienced by nurses, burnout and coping. Korean Journal of Medical Ethics, 15(3), 339-354. https://doi.org/10.35301/ksme.2012.15.3.339
  20. Lee, J. S., & Ahn, S. H. (2019). The impact of moral sensitivity and moral distress on end-of-life care performance among intensive care unit nurses. Korean Journal of Medical Ethics, 22(2), 140-160. https://doi.org/110.35301/ksme.2019.22.2.140
  21. Lim, J., Bogossian, F., & Ahern, K. (2010). Stress and coping in Australian nurses: a systematic review. International Nursing Review, 57, 22-31. https://doi.org/10.1111/j.1466-7657.2009.00765.x
  22. Morse, J. M., Barrett, M., Mayan, M., Olson, K., & Spiers, J. (2002). Verification strategies for establishing reliability and validity in qualitative research. International Journal of Qualitative Methods, 1(2), 13-22. https://doi.org/10.1177/160940690200100202
  23. Noh, D. B., Kim, S. A., & Kim, S. H. (2013). Moral distress, moral sensitivity and ethical climate of nurses working in psychiatric wards. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 22(4), 307-319. https://doi.org/10.12934/jkpmhn.2013.22.4.307
  24. Oh, E. J., & Jeong, K. S. (2019). The effect of job stress, nursing organizational culture and emotional exhaustion on retention intention among clinical nurses. The Korea Contents Society, 19(7), 464-477. https://doi.org/10.5392/JKCA.2019.19.07.467
  25. Palazoglu, C. A., & Koç, Z. (2019). Ethical sensitivity, burnout, and job satisfaction in emergency nurses. Nursing Ethics, 26(3), 809-822. https://doi.org/10.1177/0969733017720846
  26. Park, B. H., & Oh, Y. J. (2016). Moral distress experienced by nurses in South Korea: An integrated review. Korean Journal of Medical Ethics, 19(3), 312-327. https://doi.org/312-327.10.35301/ ksme.2016.19.3.312
  27. Park, Y. S., & Oh, E. G. (2012). Nurses' experiences of ethical dilemmas and their coping behaviors in intensive care units. Journal of Korean Society of Critical Care Nursing, 5(2), 1-14.
  28. Shin, J. H., Jeong, S. H., Lee, M. H., & Yang, Y. R. (2015). Experiences of ethical issues and needs for ethics education in clinical nurses. Journal of Korean Academic Nursing Administration, 21(3), 327-339. https://doi.org/10.11111/jkana.2015.21.3.327
  29. Shin, J. H., & Seo, M. H. (2018). A survey on the ethical issues and needs for ethics education of nurses in long-term care hospitals. Journal of the Korea Contents Association, 18(6), 180-192. https://doi.org/10.5392/JKCA.2018.18.06.180
  30. Yildiz, E. (2019). Ethics in nursing: A systematic review of the framework of evidence perspective. Nursing Ethics, 26(4), 1128-1148. https://doi.org/10.1177/0969733017734412