• 한국사회정책
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• 제25권2호
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• pp.57-91
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• 2018

사회적 돌봄의 급격한 성장에도 불구하고, 돌봄에 대한 이해는 분절적이고 돌봄은 여전히 주변화(marginalizing) 되어 있다. 돌봄의 사회화가 실질적으로 '절반(折半)의 사회화'에 머물고 있는 것은 돌봄을 둘러싼 사회 부정의(不正義)의 결과이다. 따라서 돌봄의 문제를 정의(Justice)의 관점에서 접근할 필요가 있다. 이 논문에서는 돌봄정의(Caring Justice)를 논함에 있어 존 롤스의 사회계약론에 기반한 사회정의 접근이 가지는 한계를 페미니스트 돌봄윤리에 관한 저작들을 통해 정리하고, Nancy Fraser의 3차원 정의기준인 (재)분배(redistribution), 인정(recognition), 대표(representation)를 기준으로 돌봄정의 개념을 새롭게 구성하였다. 이 때 돌봄의 관계적 측면에 주목하여, 돌봄정의 개념을 돌봄수혜자의 돌봄 사회권(社會權) 측면뿐만 아니라 돌봄제공자의 노동권(勞動權) 측면을 포함하는 통합적(統合的) 개념으로 구성하였다. 그리고 돌봄정의 분석틀에 입각하여 돌봄정책 이념유형(ideal types)을 도출한 다음, 한국 돌봄정책의 중심축인 노인 장기요양정책을 평가하였다. 연구결과는 다음과 같다: 첫째, 돌봄책임의 사회화 및 사회적 자원의 정당한 분배 관점에서, 특히 돌봄제공자의 노동권 강화가 필요하다. 둘째, 돌봄윤리와 돌봄의 개별화 관점에서 돌봄수혜자 및 돌봄제공자의 관계적 자율성을 보장하는 서비스 제공체계와 돌봄문화가 필요하다. 셋째, 돌봄책임을 민주적으로 배분하고 정당한 자원배분을 위하여 돌봄문제를 정치적 중심 아젠다로 다루어야 한다. 이를 위해 돌봄의 주변화(marginalization of care)로부터 돌봄의 주류화(mainstreaming of care)로의 패러다임 전환이 필요하다. 궁극적으로 돌봄사회(Caring Society)를 지향해야 한다.

• 한국콘텐츠학회논문지
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• 제18권6호
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• pp.180-192
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• 2018

본 연구는 요양병원에서 근무하는 간호사들의 윤리적 이슈와 윤리교육에 대한 요구를 파악하기 위하여 실시되었다. 연구대상자는 J도 소재 9개 요양병원에서 1년 이상 근무하고 있는 간호사로 자료수집기간은 2015년 11월 9일부터 11월 30일까지였고, 170명이 설문에 응답하였으며 이 중 총 142부가 최종분석에 사용되었다. 자료는 SPSS WIN 24.0 프로그램을 이용하여 분석하였다. 연구결과 요양병원 간호사가 경험하는 윤리적 이슈의 점수는 3점 만점의 1.23점이었으며, 가장 자주 경험하는 윤리적 이슈는 '간호사의 건강을 위협할 수 있는 상황에서의 환자 간호'로 나타났다. 그리고 가장 혼란스러운 윤리적 이슈는 '임종시기에 대한 결정'으로 파악되었다. 윤리 교육의 필요성 인식은 4점 만점에 3.11점으로 나타났으며, 가장 높은 윤리 교육의 필요성에 대한 주제는 '억제대 사용 시의 법적 윤리적 문제'로 나타났다. 또한 대상자의 다양한 특성에 따른 윤리적 이슈 경험 및 윤리교육 필요성 인식에 차이는 없는 것으로 확인되었다. 본 연구로 요양병원에 근무하는 간호사들이 경험하는 윤리적 이슈 및 윤리 교육 필요성을 확인하였으며, 이 연구 결과는 요양병원 간호사들을 위한 실제적이며 임상 현장의 맞춤식 윤리교육 컨텐츠를 개발하는데 기초자료로 활용될 수 있을 것이다.

• 가정∙방문간호학회지
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• 제29권3호
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• pp.319-328
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• 2022

Purpose: This study investigated the relationship between artificial intelligence ethical awareness, bioethics awareness, and person-centered care of general hospital nurses. Methods: The participants were 192 nurses. Data were analyzed using descriptive statistics, t-test, analysis of variance, and Pearson's correlation coefficient with the SPSS program. Results: The average points for artificial intelligence ethical awareness, bioethics awareness, and person-centered care were 2.93, 2.77, and 3.50, respectively. Artificial intelligence ethical awareness and bioethics awareness had statistically significant negative relationships. Artificial intelligence ethical awareness, bioethics awareness, and person-centered care were not significantly correlated. Conclusion: Education, training, and organizational support are needed to improve artificial intelligence ethics awareness, bioethics awareness, and person-centered care for general hospital nurses.

• 가정∙방문간호학회지
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• 제7권1호
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• pp.39-57
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• 2000

This study was conducted to identify the current situation of home care nursing research and to propose future research in the area of home care nursing in Korea. The design was a retrospective descriptive study based on 171 studies. The studies were collected from nursing academic magazines, the national library web site and dissertations on home care. The data were classified according to the independent and dependent variables which were represented in the research title. The final category classification was defined by considering the research objectives and content as found in the 171 studies. Eight categories were created to describe the results of home care nursing research in Korea. They included: home care needs. home care services. home care costs. development of home care programs and equipment. management of home care services. effectiveness of home care services, development of an educational curriculum for home care, and recognition of home care services. Based on our research we have identified other future research areas that need to be developed such as community needs assessment, standards and guidelines for home care nursing, quality assurance and quality improvement for controlling home care quality, home care informatics. and a system of home care cost and ethics.

• 간호행정학회지
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• 제21권3호
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• pp.327-339
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• 2015

Purpose: This study was done to identify the experiences of ethical issues and needs for ethics education in clinical nurses. Methods: A cross-sectional survey was used and data were collected in 2013. Participants were 428 clinical nurses working in the general units of seven medical hospitals. The Ethical Issues in Clinical Practice Tool was used. Data analysis was performed using SPSS/WIN 19.0. Results: 'Providing care with a possible risk to your health' was the most frequent and disturbing ethical problems for nurses. The highest helpful ethical topic was 'the patients' right, autonomy and informed consent'. The ethical issue experience was significantly different according to education level, work units, and type of employment. The necessity of ethics education was statistically different according to age, religion, level of education, duration of working as RN, position, shift type, and continuing education about nursing ethics. Conclusion: The results of this study show that nursing educators need to provide practical ethics education based on frequent ethical issues and helpful education topics. These findings can be used in developing effective education strategies for clinical nurses and nursing organizations to improve nurses' ethical decision-making abilities.

• 한국화재소방학회논문지
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• 제28권1호
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• pp.71-78
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• 2014

응급구조사는 병원 밖 사고 현장과 응급실의 응급의료 행위에 대해서 복잡한 윤리적 문제가 야기된다. 소방현장 및 종합병원에서 근무하는 응급구조사 500명을 대상으로 직업윤리의식과 태도, 이송한 환자에 대한 논의와 대책 그리고 임종에 관한 윤리의식을 설문하였다. 직업윤리의식과 태도, 이송한 환자에 대한 논의와 대책 그리고 임종관련에 대한 윤리의식을 설문해 보았는데 직업적 윤리의식이나 응급구조사가 가져야 할 태도가 높게 나타났다. 현장에서 응급처치나 이송한 환자에 대해서 결과를 논의하거나 예후를 알아보는 군은 자격에 따라 유의하게 나타났다. 부적절한 응급처치나 이송에 대해서는 90% 이상이 토론 후 대책을 세우는 것으로 보여 졌으나, 지난 업무에 대해서는 그냥 넘어가기를 원하는 것과 책임문제로 상관에게 보고하는 경우도 있어 도덕적으로 비윤리적인 문제도 안고 있었다. 사망진단을 내릴 수 없는 응급구조사에게 임종관련 DNAR 문제로 윤리적 갈등을 심하게 겪고 있는데, 제도적 뒷받침이 미약하여 불필요한 치료를 하고 있다. 사고현장에서 윤리적인 문제들, 특히 DNAR 교육은 필요성에 비해 교육과 지침서의 지급률이 지역과 소속마다 차이가 심하였다. 따라서 응급구조사의 직업윤리교육과 지침이 반드시 필요하며, 응급현장에서 이용 시 많은 도덕적 오류들이 줄어들 것이다.

• 가정∙방문간호학회지
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• 제29권2호
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• pp.175-182
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• 2022

Purpose: The study examined the effects of ethical sensitivity and person-environment fit on person-centered care of nurses in long-term care hospitals. Methods: The participants were 111 nurses. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis with the SPSS program. Results: The mean of person-centered care was 2.95±0.62 out of 5. There were significant differences in person-centered care in terms of age, shift pattern, total clinical career, and educational experience of person-centered care. Person-centered care and ethical sensitivity, person-centered care and person-environment fit showed a positive correlation. Factors affecting the person-centered care were the age (20-29), shift pattern (three shift), person-environment fit. The explanatory power was 42%. Conclusion: These results can be used to increase the person-environment fit and adopt a differented approach based on age and shift pattern in order to enhance person-centered care. Therefore, it is necessary to develop and apply an person-centered care program for nurses in long-term care hospitals.

• 가정∙방문간호학회지
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• 제27권2호
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• pp.210-218
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• 2020

Purpose: The purpose of this study was to analyze research trends, using the keyword home health care, in articles published in the Journal of Korean Academic Society of Home Health Care Nursing over the past 10 years. Methods: An analysis was conducted of 50 home health care-based studies chosen from among the 206 studies published in the Journal of Korean Academic Society of Home Health Care Nursing from 2010 to 2019. The analysis focused on research methodology and keyword. Descriptive statistics were used to examine the frequency distribution of research methods and keywords. Results: Study participation was mainly focused on nurses (52.0%). Most of the studies used quantitative methods (96.0%), and 43 studies (86.0%) used self-report structured questionnaires. The most commonly used data analyses methods were descriptive statistics, t-test, analysis of variance, correlation, and regression. Major keywords were home health nursing, elderly care facility, visiting nurse, home care service, home healthcare nurse, home care agencies, long-term care, and home care. Conclusion: The results of this study identified current trends and interests in the Journal of Korean Academic Society of Home Health Care Nursing. This study suggests that future studies include a variety of research methods and maintain appropriate standards of research ethics.

• 지역사회간호학회지
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• 제22권1호
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• pp.33-44
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• 2011

Purpose: This study examined the characteristics and service utilization of home nursing care beneficiaries under the Korean Long-Term Care Insurance (LTCI). Methods: We used assessment data and claim data of National Health Insurance Corporation from July to August 2008. Data were composed of subjects who were the beneficiaries of home nursing care. Results; A total of 634 subjects were analyzed. Of the subjects, 57.1% were 75 years and over. The average score of nursing care need was only 0.71 and the percentage of those whose nursing care need score was zero was 58.0%. More than half of the subjects had partially dependent musculoskeletal conditions, and 75.5% had two or more comorbidities. A third of them usedonly home nursing care, and another third used both home nursing care and general home care at the same time. Those who needed sore care used the largest home nursing care benefits. Conclusion: Home nursing care of LTCI performs community-based healthcare services under LTCI. Throughout the past two years, however, it has not been active. Understanding the characteristics of its users is important in order to develop effective strategies for activating home nursing care.

• Journal of Hospice and Palliative Care
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• 제25권4호
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• pp.159-168
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• 2022

Purpose: This study aimed to investigate the impacts of end-of-life care competency and ethical dilemmas on psychological burnout in nurses who care for terminal cancer patients. Methods: A cross-sectional study of 160 nurses who cared for terminal cancer patients was conducted. The participants were recruited from the hospice-palliative care wards, hematology or oncology wards, or intensive care units of three general hospitals in a single metropolitan area. Data were collected using a self-administered survey to assess end-oflife care competency, ethical dilemmas, psychological burnout, and general sociodemographic characteristics. Data were analyzed using descriptive statistics, the independent ttest, analysis of variance, Pearson correlation coefficients, and hierarchical linear regression analysis using SPSS for Windows (version 26.0). Results: Psychological burnout was significantly correlated with end-of-life care competency (r=-0.23, P=0.003) but not with ethical dilemmas. The results of the hierarchical linear regression analysis indicated that endof-life care competency (β=-0.280, P=0.010) and ethical dilemmas (β=0.275, P=0.037) were significant predictors of psychological burnout, after adjusting for age, religious status, clinical experience, and unit type. Conclusion: The current study's findings demonstrate that end-of-life care competency and ethical dilemmas are crucial factors that affect psychological burnout in nurses who care for terminal cancer patients. Substantive education programs must be developed to improve nurses' competencies in end-of-life care and ethical dilemmas to decrease psychological burnout.