Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Death Anxiety and Terminal Care Stress among Nurses and the Relationship to Terminal Care Performance

간호사의 죽음불안과 임종간호스트레스 및 임종간호수행

  • Received : 2012.11.29
  • Accepted : 2013.02.05
  • Published : 2013.03.01
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Abstract

Purpose: This study was conducted to examine how nurses' death anxiety and terminal care stress affect their terminal care performance in the clinical setting. Methods: The study enrolled 180 registered nurses with experience of attending dying patients at a university hospital located in Seoul, Korea. Collected data were analyzed with descriptive statistics, one-way ANOVA and Pearson's correlation using SPSS 18.0 for Windows. Results: Nurses showed significant differences in the level of death anxiety and terminal care stress as well as terminal care performance by working division, marital status, educational background and hospice training. A significant relationship was found between terminal care stress and terminal care performance. Conclusion: The study results showed that efforts to ease nurses' death anxiety and terminal care stress could improve their terminal care performance. Further study should be conducted to investigate other factors that affect nurses' terminal care performance from various perspectives and develop a terminal care manual which can be used as guidance for nurses in charge of terminal patient care.

목적: 본 연구는 간호사의 죽음불안과 임종간호스트레스 및 임종간호수행과의 관계를 확인하고 임상간호현장에서 임종간호수행의 질 향상을 도모하기 위해 시도되었다. 방법: 연구의 대상은 180명의 서울시내 일개 대학병원에 근무하는 임종간호경험이 있는 간호사이다. 자료의 분석은 SPSS 18.0 프로그램을 이용하여 서술통계와 One-way ANOVA, Pearson's 상관계수를 확인하였다. 결과: 대상자의 일반적 특성에 따른 죽음불안과 임종간호스트레스, 임종간호수행의 차이는 근무부서, 결혼여부, 교육정도 및 호스피스 교육경험에 따라 차이가 있었다. 또한 임종간호스트레스와 임종간호수행 간에는 통계적으로 유의한 상관관계가 있는 것으로 나타났다. 결론: 간호사들의 죽음불안과 임종간호스트레스 감소를 위한 노력을 통해 임종간호수행의 향상을 가져올 수있을 것으로 사료된다. 따라서 간호사의 임종간호수행 향상을 위해서는 이에 영향을 미치는 요인을 파악하고 다양한 수준에서 간호사의 임종간호수행을 위한 프로그램 개발과 호스피스교육이 필요할 것이다.

Keywords

References

  1. Statistics Korea: 2010 annual report on the cause of death statistics [Internet]. Daejeon: Statistics Korea; c2011. [cited 2011 Sep 15]. Available from: http://www.kostat.go.kr.
  2. Yi M. Nurses' experience of caring for dying patients in hospitals. J Korean Acad Nurs 2003;33:553-561.
  3. HIRAS: Analysis medical treatment payment 2005-2010 [Internet]. Seoul: Health Insurance Review & Assessment Service; c2010. [cited 2012 April 20]. Available from: http://www.hira.or.kr.
  4. Choi ES, Kim KS. Content analysis with counseling cancer patients and their relatives in outpatient hospice office. Korean J Rehabil Nurs 2005;8:50-58.
  5. Mularski RA, Puntillo K, Varkey B, Erstad BL, Grap MJ, Gilbert HC, et al. Pain management within the palliative and end-of-life care experience in the ICU. Chest 2009;135:1360-1369. https://doi.org/10.1378/chest.08-2328
  6. Choi JY. A comparison of perceived nursing needs among oncology nurses, patients with non-terminal cancer and patients with terminal cancer. J Korean Acad Nurs 2005;35:1135-1143. https://doi.org/10.4040/jkan.2005.35.6.1135
  7. Detering KM, Hancock AD, Reade MC, Silvester W. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMC 2010;340:c1345. https://doi.org/10.1136/bmj.c1345
  8. Kang SE, Lee BS. The lived experience of nursing care for the dying patients in clinical nurses. J Korean Acad Nurs Admin 2001;7:237-251.
  9. Seo YS, Sung KW. Influence of nurses' spirituality on hospice nursing intervention in long-term care facilities. J Korean Gerontol Nurs 2012;14:12-20.
  10. Lee EH, Chang SJ, Kim HO, Roh JH, Park EJ, Won JU. Relationship between job stress and turnover of registered nurses in a university hospital. Korean J Occup Environ Med 2007;19: 93-104.
  11. Tunnah K, Jones A, Johnstone R. Stress in hospice at home nurses: a qualitative study of their experiences of their work and wellbeing. Int J Palliat Nurs 2012;18:283-289. https://doi.org/10.12968/ijpn.2012.18.6.283
  12. Han J, Lee N. Nursing students' attitude toward death and perception on hospice care. J Korean Oncol Nurs 2009;9:95-103.
  13. Deffner JM, Bell SK. Nurses' death anxiety, comfort level during communication with patients and families regarding death, and exposure to communication education: a quantitative study. J Nurses Staff Dev 2005;21:19-23. https://doi.org/10.1097/00124645-200501000-00005
  14. Cho MO. Experiences of ICU nurses on temporality and spatiality in caring for dying patients. Qual Res 2010;11:80-93.
  15. Lim SH, Chang SO, Kim MS. Nurses' perceptions regarding sign and symptom management in end of life care in nursing homes. J Korean Acad Fundam Nurs 2010;17:209-219.
  16. Kim SN, Kim HJ, Choi SO. Effects of a hospice and palliative care education program including meaning in life on attitudes toward end-of-life care and meaning in life among nursing college students. J Korean Acad Soc Nurs Edu 2011;17:454-463. https://doi.org/10.5977/JKASNE.2011.17.3.454
  17. Park SJ, Choi SH. A study on the degrees of death orientation and terminal care performance of nurses. J Korean Acad Fundam Nurs 1996;3:285-297.
  18. Hansen L, Goodell TT, Dehaven J. Smith M. Nurses' perceptions of end-of-life care after multiple interventions for improvement. Am J Crit Care 2009;18:263-271. https://doi.org/10.4037/ajcc2009727
  19. Lee HY, Lee YO, Choi EY, Park YM. A comparison on stress and coping of bereavement care between nurses in the cancer unit and nurses in the general unit. J Korean Oncol Nurs 2007; 7:26-35.
  20. Cho IH, Kim BH. The study on perception about cancer patients. J Korean Oncol Nurs Nursing 2001;1:252-253.
  21. Thorson JA, Powell FC. A revised death anxiety scale. Death Stud 1992;16:507-521. https://doi.org/10.1080/07481189208252595
  22. Park EK. Development of an instrument to measure death anxiety [master's thesis] Seoul: Korea University.; 1995. Korean.
  23. Kim MH, Lee BS. Death anxiety and attitude on death in hospice volunteers. Keimyung J Nurs Sci 2009;13:85-94.
  24. Mealer M, Jones J, Moss M. A qualitative study of resilience and posttraumatic stress disorder in United States ICU nurses. Intensive Care Med 2012;38:1445-1451. https://doi.org/10.1007/s00134-012-2600-6
  25. Ward-Griffin C, McWilliam CL, Oudshoorn A. Relational experiences of family caregivers providing home-based end-of-life care. J Fam Nurs 2012;18:491-516. https://doi.org/10.1177/1074840712462134
  26. Callahan MF, Breakwell S, Suhayda R. Knowledge of palliative and end-of-life care by student registered nurse anesthetists. AANA J 2011;79(4 Suppl):S15-S20.
  27. Choi M, Lee J, Kim SS, Kim D, Kim H. Nurses' knowledge about end-of-life care: where are we? J Contin Educ Nurs 2012; 43:379-384. https://doi.org/10.3928/00220124-20120615-35
  28. Caton AP, Klemm P. Introduction of novice oncology nurses to end-of-life. Clin J Oncol Nurs 2006;10:604-608. https://doi.org/10.1188/06.CJON.604-608
  29. Crump SK, Schaffer MA, Schulte E. Critical care nurses' perception of obstacle, supports, and knowledge needed in providing quality end-of-life care. Dimens Crit Care Nurs 2010;29:297-306. https://doi.org/10.1097/DCC.0b013e3181f0c43c
  30. Chi KA, Kim EJ. Factors influencing nurse's attitude toward hospice. J Korean Acad Psychiatr Ment Health Nurs 2005;14: 285-291.

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