Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
권호 표지
DOI QR코드

DOI QR Code

Awareness of Good Death and Attitudes toward Terminal Care among Geriatric Hospital Nurses

노인요양병원 간호사의 좋은 죽음인식과 임종간호태도

  • An, Mi Sook (Department of Nursing, Graduate School of Public Administration, Gachon University) ;
  • Lee, Keum Jae (Department of Nursing, Gachon University)
  • 안미숙 (가천대학교 행정대학원 간호관리전공) ;
  • 이금재 (가천대학교 간호학과)
  • Received : 2013.09.02
  • Accepted : 2014.07.18
  • Published : 2014.09.01
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: We conducted a descriptive correlational study to determine a relationship between nurses' awareness of good death and attitudes toward terminal care, which in turn could be used as basic data for improvement of the quality of terminal care at geriatric hospitals. Methods: From April 3, 2013 through April 22, 2013, data were collected from 230 nurses working at geriatric hospitals. Results: Nurses' attitudes toward terminal care showed no significant correlation with awareness of good death, but it was positively correlated with a sense of closeness, a subfactor of awareness of good death. There was negative correlation between emotions regarding a deathbed, a subfactor of attitudes of nurses in charge of terminal patients, and awareness of good death. We found positive correlation between terminal care performance and awareness of good death. Conclusion: This study warrants the need for nursing education catered to characteristics of geriatric hospitals and development of diverse intervention strategies to help them to attain a positive attitude toward death by familiarizing themselves with the concept of good death and enhancing job satisfaction.

목적: 본 연구는 노인요양병원 간호사의 좋은 죽음에 대한 인식과 임종간호태도 간의 관계를 파악하여, 노인요양병원에서 임종간호의 질을 높이기 위한 기초자료를 제공하고자 시도된 서술적 상관관계 조사연구이다. 방법: 대상자는 서울 및 경기도에 소재한 10개 노인요양병원에 근무하는 간호사 230명을 대상으로 하였고, 자료 수집은 2013년 4월 3일부터 4월 22일까지 하였다. 연구 도구는 인구사회학적 특성 7문항, 죽음 및 임종간호 관련 특성 10문항, Schwartz 등(2003)이 개발한 좋은 죽음인식 척도 17문항, Frommelt(1991)가 개발한 임종간호태도 척도 30문항 등 총 64문항을 사용하였다. 자료는 SPSS/WIN 18.0 프로그램을 이용하여 기술통계, t-test, ANOVA, scheffe test, pearson's Correlation Coefficient을 사용하여 분석하였다. 결과: 첫째, 대상자의 좋은 죽음인식 정도는 평균 $3.13{\pm}0.33$점(4점 만점), 임종간호태도 정도도 평균 $2.94{\pm}0.27$점(4점 만점)으로 보통 이상이었다. 둘째, 좋은 죽음 인식 정도의 차이는 연령, 직무만족에서 유의한 차이가 있었으며, 임종간호태도 정도의 차이는 학력, 종교, 종교중요성 인지, 임종간호경험, 좋은 죽음 교육경험, 좋은 죽음 생각빈도, 임종간호 교육경험, 직무만족, 삶의 만족에서 유의한 차이가 있었다. 셋째, 임종간호태도는 좋은 죽음인식과의 상관관계에서 유의하지 않았으나, 좋은 죽음인식의 하위 요인인 친밀감과 유의한 정의 상관관계가 있는 것으로 나타났다. 임종간호태도의 하위 요인인 임종정서와 좋은 죽음인식 간에는 역의 상관관계가 있는 것으로, 임종간호수행과 좋은 죽음인식 간에는 정의 상관관계가 있는 것으로 나타났다. 결론: 임종간호태도를 긍정적으로 하기 위해서는 좋은 죽음인식의 친밀감을 고취시킬 수 있고 직무만족을 높이기 위한 노인요양병원 특성에 맞는 교육과 다양한 중재전략이 개발되어야 한다.

Keywords

References

  1. Cause of death and statistics [Internet]. Seoul: Statistics; 2012. [cited 2013 Aug 12]. Available from: http://www.kosis.kr.
  2. A survey on the status of elders [Internet]. Seoul: Ministry of Health and Welfare; 2012. [cited 2013 Aug 12]. Available from: http://www.mw.go.kr.
  3. Cho YK. Activation of hospice service in rehabilitation hospitals for senior citizens [master's thesis]. Gyoengnam: Kaya Univ.; 2011. Korean.
  4. Status of health care resources [Internet]. Seoul: Health Insurance Review and Assessment Service; 2013. [cited 2013 Aug 12]. Available from: http://www.hira.or.kr.
  5. Yoon SJ. A study for the factors on choosing hospitals and patients satisfaction between geriatric hospitals and general hospitals [master's thesis]. Seoul: Yonsei Univ.; 2003. Korean.
  6. Seo MJ, Kim JY, Kim SH, Lee TW. Nurses attitudes toward death, coping with death and understanding and performance regarding EOL care : focus on nurses at ED, ICU and oncology department. Korean J Hosp Palliat Care 2013;16:108-17. https://doi.org/10.14475/kjhpc.2013.16.2.108
  7. Lee HJ. A study on nurse's attitude toward death and hospice [master's thesis]. Busan: Dong-A Univ.; 2002. Korean.
  8. Ferrell B, Coyle N. Textbook of palliative nursing. New York: Oxford University Press;2001.
  9. Park YM. Death with dignity [master's thesis]. Seoul: Hanyang Univ.; 2007. Korean.
  10. Lee MS. A study on identifying good death [dissertation]. Chungnam: Hanseo Univ.; 2012. Korean.
  11. Kim SM, Lee YJ, Kim SY. Attributes considered important for a good death among elderly and adults. J Korean Geron Soc 2003;23:95-110.
  12. Ku IH. The meaning of death and its moral problems for modern human being. Philos Investig 2004;16:59-81.
  13. Lee GJ, Hwang KH, Ra JR, Hong JA, Park CS. Concept analysis of good death. Res Institute Hosp Palliat Care 2006;10:23-39.
  14. Proulx K, Jacelon C. Dying with dignity: the good patient versus the good death. Am J Hosp Palliat Care 2004;21:116-20. https://doi.org/10.1177/104990910402100209
  15. Kim MH, Kwon KJ, Lim YO. Study on 'good death' that korean aged people recognize - blessed death. J Korean Soc Welfare 2004; 56:195-213.
  16. Erikson EH. The life cycle completed. New York:W. W. Norton & Co.;1982.
  17. Oh JT. Death, the final stage of growing. Today's Eastern Thought 2004;11:444-61.
  18. Kang SY. The lived experience of nursing care for the dying patients in clinical nurses [master's thesis]. Daegu: Keimyung Univ.; 2000. Korean.
  19. Ali WGM, Ayoub NS. Nurses' attitudes toward caring for dying patient in Mansoura University hospitals. J Med Biomed Sci 2010;1: 16-23.
  20. Cha YR. A study on the nurses' attitude to death in Korea - centering on university hospital in Jeollabuckdo province [master's thesis]. Iksan: Wonkwang Univ.; 2006. Korean.
  21. Kubler-Ross E. On death and dying. New York:Macmillian;1969.
  22. Kim AK, Park GS. The study of meaning in euthanasia and hospice nursing among nurses. J Korean Acad Fund Nurs 2000;7:379-90.
  23. Stewart AE, Lord JH, Mercer DL. A survey of professionals' training and experiences in delivering death notifications. Death Stud 2000; 24:611-31. https://doi.org/10.1080/07481180050132811
  24. Lee MS. Nurses' experience of caring for dying patients in hospitals. J Korean Acad Nurs 2003;33:553-61.
  25. Lee YJ. A study on nurse's awareness and attitudes about death and the hospice [master's thesis]. Daejeon: Daejeon Univ.; 2004. Korean.
  26. Benoliel JQ. Multiple meanings of death for older adults. In: Baines EM. Perspective on gerontological nursing. Newbury Park, Calif.:Sage Publications;1991.
  27. Schwartz CE, Mazor K, Rogers J, Ma Y, Reed G. Validation of a new measure of concept of a good death. J Palliat Med 2003;6:575-84. https://doi.org/10.1089/109662103768253687
  28. Jeong HS. Recognition towards good death among physicians and nurses in an area [master's thesis]. Busan: Catholic Univ.; 2010. Korean.
  29. Song G. Will it be realized legislating discontinuance of treatment of life prolongation [Internet]. Seoul: Yonhapnews; 2013. [cited 2013 Aug 12]. Available from: http://www.yonhapnews.co.kr.
  30. Steinhauser KE, Clipp EC, McNeilly M, Christakis NA, McIntyre LM, Tulsky JA. In search of a good death; observation of patients, families, and providers. Ann Intern Med 2000;132:825-32. https://doi.org/10.7326/0003-4819-132-10-200005160-00011
  31. Cho HJ. The effect of the death education program on the death anxiety and attitudes toward nursing care of the dying patients of nursing student [master's thesis]. Jinju: Gyoeng-sang National Univ.; 2004. Korean.
  32. Costello J. Dying well: nurses' experiences of 'good and bad' death in hospital. J Adv Nurs 2006;54:594-601. https://doi.org/10.1111/j.1365-2648.2006.03867.x
  33. Noh SS. A study on death perception, terminal care attitude, and terminal care performance of clinical nurses caring for cancer patients [master's thesis] Seoul: Sungkyunkwan Univ.; 2010. Korean.
  34. Eo DY. Nurses' death anxiety and attitude concerning hospice care [master's thesis]. Busan: Catholic Univ.; 2010. Korean.
  35. Kim SE. Relationship between intensive care unit nurses' death perception and terminal care performance [master's thesis]. Suwon: Ajou Univ.; 2011. Korean.
  36. Cho YC. Emergency nurses' perception of death and terminal care attitude [master's thesis]. Suwon: Ajou Univ.; 2011. Korean.
  37. Quenot JP, Rigaud JP, Prin S, Barbar S, Pavon A, Hamet M, et al. Suffering among carers working in critical care can be reduced by an intensive communication strategy on end-of-life practices. Intensive Care Med 2012;38:55-61. https://doi.org/10.1007/s00134-011-2413-z
  38. riss.kr [Internet]. Daegu: Korea Education and Research Information Service; c1996-2013. [cited 2013 Aug 12]. Available from: http:// www.riss.kr.
  39. Park SH. A study of psychological reaction and coping methods on death [master's thesis]. Seoul: Sangmyung Univ.; 2010. Korean.
  40. Higuchi K. Preparation education for death. Lee WH, Translator. Seoul:Moonumsa;1995.
  41. Chi KA. Influence of spiritual health, mental health and death orientation on the nurse's attitude toward hospice [master's thesis]. Daejeon: Daejeon Univ.; 2004. Korean.
  42. Frommelt KH. The effects of death education on nurses' attitudes toward caring for terminally ill persons and their families. Am J Hosp Palliat Care 1991;8:37-43.
  43. Shin HJ. The influence of performance of terminal care on professionalism and good death awareness in clinical nurses [master's thesis]. Chungju: Chungju National Univ.; 2012. Korean.
  44. Han NY, Yoon HJ, Park EW, Cheong YS, Yoo SM. Perception of a good death in the elderly. J Korean Acad Fam Med 2002;23:769-77.
  45. Kim MS. Philosophical studies on cognition and attitude of Koreans towards death. J Confucianism Res 2010;22:73-108.
  46. Chan WC, Epstein I. Researching "good death" in a Hong Kong palliative care program: a clinical data-mining study. Omega (Westport) 2011-2012;64:203-22.
  47. Yoon YA. Clinical nurses' perception of death and end of life care stress [master's thesis]. Daegu: Kyungpook National Univ.; 2010. Korean.
  48. Park SJ. A study on the degrees of death orientation and terminal care performance of nurses [master's thesis]. Gwangju: Chonnam national Univ.; 1996. Korean.
  49. Braun M, Gordon D, Uziely B. Associations between oncology nurses' attitudes toward death and caring for dying patients. Oncol Nurs Forum 2010;37:E43-9. https://doi.org/10.1188/10.ONF.E43-E49
  50. Watts T. End-of-life care pathways as tools to promote and support a good death: a critical commentary. Eur J Cancer Care (Engl) 2012;21:20-30. https://doi.org/10.1111/j.1365-2354.2011.01301.x

Cited by

  1. Recognition of Good Death, Attitude towards the Withdrawal of Life-Sustaining Treatment, and Attitude towards Euthanasia in Nurses vol.19, pp.2, 2016, https://doi.org/10.14475/kjhpc.2016.19.2.136
  2. The Effects of the Hospice & Palliative Care Education Program for Caregivers vol.21, pp.1, 2018, https://doi.org/10.14475/kjhpc.2018.21.1.33
  3. Hospice care education needs of nursing home staff in South Korea: a cross-sectional study vol.18, pp.1, 2019, https://doi.org/10.1186/s12904-019-0405-x
  4. Influence of Perceptions of Death, End-of-Life Care Stress, and Emotional Intelligence on Attitudes towards End-of-Life Care among Nurses in the Neonatal Intensive Care Unit vol.25, pp.1, 2019, https://doi.org/10.4094/chnr.2019.25.1.38
  5. 노인요양병원 간호사의 죽음 인식, 영적 안녕과 임종간호 스트레스의 관계 연구 vol.17, pp.6, 2014, https://doi.org/10.5762/kais.2016.17.6.510
  6. 응급실 간호사의 죽음에 대한 인식, 영적안녕이 삶의 질에 미치는 영향 vol.22, pp.2, 2016, https://doi.org/10.14370/jewnr.2016.22.2.129
  7. 간호 대학생의 죽음인식과 웰다잉이 임종간호태도에 미치는 영향 vol.18, pp.3, 2014, https://doi.org/10.5762/kais.2017.18.3.63
  8. Concept Analysis of Good Death in the Korean Community vol.19, pp.1, 2014, https://doi.org/10.17079/jkgn.2017.19.1.28
  9. 간호대학생의 생명의료윤리 의식, 좋은 죽음 인식, 자아존중감이 연명치료 중단에 대한 태도에 미치는 영향 vol.19, pp.5, 2018, https://doi.org/10.5762/kais.2018.19.5.275
  10. 임상실습을 경험한 간호 대학생의 죽음의식과 좋은 죽음 인식에 대한 연구 vol.16, pp.10, 2014, https://doi.org/10.14400/jdc.2018.16.10.271
  11. 요양병원 근무자의 호스피스 완화돌봄 지식과 인식, 임종돌봄 태도, 죽음에 대한 인식이 임종돌봄 수행에 미치는 영향 vol.21, pp.4, 2014, https://doi.org/10.14475/kjhpc.2018.21.4.124
  12. 간호학과 졸업예정자의 좋은 죽음에 대한 인식, 호스피스 완화의료 지식 및 인식 vol.18, pp.12, 2014, https://doi.org/10.5392/jkca.2018.18.12.624
  13. 심혈관대사질환이 있는 지역사회 거주 환자의 질환경험 및 완화의료 요구 vol.22, pp.1, 2014, https://doi.org/10.14475/kjhpc.2019.22.1.8
  14. 종합병원 간호사의 임종간호 수행에 미치는 영향 vol.22, pp.1, 2014, https://doi.org/10.35301/ksme.2019.22.1.53
  15. 간호대학생의 사전의료의향서에 대한 태도 영향 요인 vol.25, pp.2, 2019, https://doi.org/10.5977/jkasne.2019.25.2.227
  16. 중환자실 간호사의 좋은 죽음과 연명의료결정에 대한 인식이 임종간호태도에 미치는 영향 vol.12, pp.2, 2014, https://doi.org/10.34250/jkccn.2019.12.2.39
  17. The Effect of Nurses’ Compassion Competence on Performance of Terminal Care in Geriatric Hospitals vol.44, pp.3, 2014, https://doi.org/10.21032/jhis.2019.44.3.253
  18. 요양병원 간호제공자의 좋은 죽음인식, 영적안녕이 노인간호수행에 미치는 영향 vol.36, pp.3, 2014, https://doi.org/10.12925/jkocs.2019.36.3.975
  19. Factors Influencing Respect for Life and Will of Korean Nursing Students vol.17, pp.11, 2014, https://doi.org/10.14400/jdc.2019.17.11.427
  20. 일 종합병원 간호사의 영성과 임종간호태도와의 관계에서 공감역량의 매개효과 vol.25, pp.2, 2019, https://doi.org/10.14370/jewnr.2019.25.2.166
  21. 한국 간호대학생의 생명존중의지에 영향을 미치는 요인 vol.5, pp.4, 2014, https://doi.org/10.17703/jcct.2019.5.4.243
  22. Systematic Review on the Influencing Factors of Nurses' and Nursing Students' Attitudes Toward Hospice and Palliative Care vol.22, pp.2, 2014, https://doi.org/10.1097/njh.0000000000000627
  23. 간호사의 임종간호 태도에 미치는 영향요인 vol.13, pp.1, 2014, https://doi.org/10.34250/jkccn.2020.13.1.76
  24. 죽음과 애도에 대한 고찰과 교육 가능성 탐색: 죽음 교육에 앞서 죽음에 대한 반응으로서의 '애도'를 어떻게 볼 것인가 vol.22, pp.3, 2014, https://doi.org/10.17496/kmer.2020.22.3.163