DOI QR코드

DOI QR Code

Factors Influencing Performance of End-of-life Care by ICU Nurses

중환자실 간호사의 임종간호수행에 영향을 미치는 요인

  • Received : 2016.07.27
  • Accepted : 2016.10.24
  • Published : 2016.12.31

Abstract

Purpose: This study was a descriptive research to assess the level of and the relationship of related factors in the performance of end-of-life care by intensive care unit (ICU) nurses. Methods: Participants were 238 ICU nurses from university and general hospitals. Data were collected, using structured questionnaires, and collected data were analyzed using t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson correlation coefficients, and multiple regression analysis with SPSS/WIN 22.0. Results: There were significantly positive effects between performance of end-of-life care and end-of-life care attitudes. Performance end-of-life care was negatively associated with end-of-life care stress and obstacles. Factors that significantly influenced ICU nurses' performance of end-of-life were end-of-life care stress, medical team in obstacles related to end-of-life care, and end-of-life care attitudes, which explained about 53% of the variance in the performance of end-of-life care. Conclusion: Findings indicate that hospital organizations should carry out stress management and counseling programs in order to lower ICU nurses' end-of-life care stress, and to enhance end-of-life care attitudes. In addition, concern needs to be given to the medical team which was one of the obstacles to end-of-life care. It is also necessary to decrease the heavy workload and increase the communication with medical workers.

Keywords

References

  1. Statistics Korea. 2015 Birth, death statistics [Internet]. 2016 Feb [cited 2016 May 31]. Available from: http://kostat.go.kr/portal/korea/kor_ko/5/2/index.board?bmode=read&aSeq=351953
  2. National Cancer Center. Hospice and palliative medical designation [Internet]. 2016 [cited 2016 May 9]. Available from: http://www.ncc.re.kr/main.ncc?uri=manage01_8
  3. Statistics Korea. Cause of death statistics [Internet]. 2015 [cited 2015 Sep 25]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1B34E13&vw_cd=MT_OTITLE&list_id=MT_CTITLE_1&scrId=&seqNo=&lang_mode=ko&obj_var_id=&itm_id=&conn_path=E1
  4. Moon JY, Shin YS. The end-of-life care in the intensive care unit. Korean J Crit Care Med. 2013;28(3):163-72. https://doi.org/10.4266/kjccm.2013.28.3.163
  5. Kang JH, Han SJ. A study of intensive care unit nurses’ understanding of the meaning of death, death anxiety, death concern and respect for life. Korean J Hosp Palliat Care. 2013;16 (2):80-9. https://doi.org/10.14475/kjhpc.2013.16.2.080
  6. Yang SA. Convergence analysis of the factors influencing terminal care attitude. Journal of Korea Convergence Society. 2015;6(4):73-88. https://doi.org/10.15207/JKCS.2015.6.4.073
  7. Son YL, Seo YS. A study on ethical attitude to DNR and terminal care performance of hospital nurse. Korean Clinical Health Science. 2015;3(2):361-71. https://doi.org/10.15205/kschs.2015.3.2.361
  8. Woo YH, Kim KH, Kim KS. Death anxiety and terminal care stress among nurses and the relationship to terminal care performance. Korean J Hosp Palliat Care. 2013;16(1):33-41. https://doi.org/10.14475/kjhpc.2013.16.1.033
  9. Chung SY. A study on terminal care stress and terminal care performance of ICU nurse [master's thesis]. [Seoul]: Hanyang University; 2013. 70 p.
  10. Lee HJ. Critical care nurses' perceived end of life care competencies and supportive behaviors and barriers [master's thesis]. [Seoul]: Seoul National University; 2015. 114 p.
  11. 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(2):108-17. https://doi.org/10.14475/kjhpc.2013.16.2.108
  12. Kim HA, Kim KB. The conflicts in nurses caring DNR (donot- resuscitate) patients. Journal of East-West Nursing Research. 2011;17(2):139-48
  13. Woo MK, Kim MK. Nurses' experiences of Do-Not-Resucitate (DNR) by the narrative inquiry. Korean J Adult Nurs. 2013;25(3):322-31. https://doi.org/10.7475/kjan.2013.25.3.322
  14. Cho HJ, Kim ES. The effect of the death education program on the death anxiety and attitude toward nursing care of the dying patients of nursing student. Korean J Hosp Palliat Care. 2005;8(2):163-72.
  15. Lee SH, Kim JS, Hwang MJ, Hwang BD, Park YJ. Ethical dilemma associated with DNR: the attitude of clinical nurse. Journal of Korean Clinical Nursing Research. 1998;4(1):142-62.
  16. Mun JH, Kim SM. Nurses' emotional responses and ethical attitudes towards elderly patients' DNR decision. J Hosp Palliat Care. 2013;16(4):216-22. https://doi.org/10.14475/kjhpc.2013.16.4.216
  17. Lee YO. A study of cancer unit nurses' stress from bereavement support [master's thesis]. [Seoul]: Kyung Hee University; 2004. 70 p.
  18. Chung MJ, Eun Y. Development and effectiveness of a spiritual care education program for nursing students-based on the ASSET model. J Korean Acad Nurs. 2011;41(5):673-83. https://doi.org/10.4040/jkan.2011.41.5.673
  19. 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(5):37-43.
  20. Burns JP, Edwards J, Johnson J, Cassem NH, Truog RD. Donotresuscitate order after 25 years. Crit Care Med. 2003;31(5):1543-50. https://doi.org/10.1097/01.CCM.0000064743.44696.49
  21. Kim SJ. Death anxiety and terminal care attitudes of nurses in hospice palliative units. Nursing Science. 2015;27(1):23-34.
  22. Lee YE, Choi EJ, Park JS. Effects of hospice and palliative care education on knowledge of hospice and palliative care and attitude toward death in nursing students. J Korean Public Health Nurs. 2012;26(2):280-8. https://doi.org/10.5932/JKPHN.2012.26.2.280
  23. Jo KH. Nurse’s conflict experience toward end-of-life medical decision-making. Korean J Adult Nurs. 2010;22(5):488-98.
  24. Lee KO, Yun HJ. Correlation between the self-esteem, spiritual wellbeing, depression, and quality of life in nurse caring of cancer patients. The Medical Journal of Chosun University. 2006;31(2):85-99.
  25. Ji SI, You HS. The impact of clinical nurses' terminal care attitude and spiritual health on their terminal care stress. Korean J Hosp Palliat Care. 2014;17(4):232-40. https://doi.org/10.14475/kjhpc.2014.17.4.232
  26. Beckstrand RL, Kirchhoff KT. Providing end-of-life care to patients: critical care nurses’ perceived obstacles and supportive behaviors. Am J Crit Care. 2005;14(5):395-403.
  27. Lee SW, Lee EO, Huh DS, Noh KH, Kim HS, Kim SR, et al. The study on the medial and nursing service needs of the terminal cancer patients and their caregivers. J Korean Acad Nurs. 1998; 28(4):958-69. https://doi.org/10.4040/jkan.1998.28.4.958
  28. Jo MJ, Jun WH. Effects of end-of-life care education using selfreflection diary on spirituality, death orientation, and attitudes toward nursing care of the dying patients in nursing students. Journal of the Korea Contents Association. 2015;15(12):294-303. https://doi.org/10.5392/JKCA.2015.15.12.294
  29. Ko SH, Chung BY. Nursing professionalism and job satisfaction of nurses in general hospital. J Korean Acad Nurs Adm. 2004;10(3):335-44.
  30. Lee KH, Gwon HJ. An analytical study on the major obstacles in nursing care for the dying patients. The Official Journal of Research Institute of Medical Science of Korea. 1983;15(2):99-107.

Cited by

  1. 일 상급종합병원 간호사의 임종간호스트레스와 임종간호수행 간의 관계에 미치는 공감역량과 극복력의 매개효과 vol.20, pp.4, 2017, https://doi.org/10.14475/kjhpc.2017.20.4.253
  2. The influence of Nursing Professionalism, Attitudes toward Advance Directive, and Death Anxiety on Terminal Care Performance of Nurses in Long-term Care Hospitals vol.30, pp.2, 2016, https://doi.org/10.7475/kjan.2018.30.2.183
  3. 요양병원 근무자의 호스피스 완화돌봄 지식과 인식, 임종돌봄 태도, 죽음에 대한 인식이 임종돌봄 수행에 미치는 영향 vol.21, pp.4, 2016, https://doi.org/10.14475/kjhpc.2018.21.4.124
  4. Relationship of ICU Nurses' Difficulties in End-of-Life Care to Moral Distress, Burnout and Job Satisfaction vol.25, pp.1, 2019, https://doi.org/10.11111/jkana.2019.25.1.42
  5. 중환자실 간호사의 죽음 인식, 임종간호 태도, 정신건강이 임종간호 스트레스에 미치는 영향 vol.25, pp.3, 2016, https://doi.org/10.22650/jkcnr.2019.25.3.323
  6. 호스피스 관련 국내 간호연구 논문 동향(1998~2017) vol.22, pp.1, 2016, https://doi.org/10.14475/kjhpc.2019.22.1.19
  7. 종합병원 간호사의 임종간호 수행에 미치는 영향 vol.22, pp.1, 2016, https://doi.org/10.35301/ksme.2019.22.1.53
  8. 일개 종합병원 간호사의 임종간호 스트레스에 영향을 미치는 융합적인 요인 vol.9, pp.4, 2016, https://doi.org/10.22156/cs4smb.2019.9.4.028
  9. 중환자실 간호사의 임종간호 어려움과 임종간호 교육요구 조사: 혼합연구방법 vol.22, pp.2, 2016, https://doi.org/10.14475/kjhpc.2019.22.2.87
  10. 중환자실 간호사의 도덕적 민감성과 도덕적 고뇌가 임종간호수행에 미치는 영향 vol.22, pp.2, 2019, https://doi.org/10.35301/ksme.2019.22.2.140
  11. 중환자실 간호사의 좋은 죽음과 연명의료결정에 대한 인식이 임종간호태도에 미치는 영향 vol.12, pp.2, 2016, https://doi.org/10.34250/jkccn.2019.12.2.39
  12. The Effect of Nurses’ Compassion Competence on Performance of Terminal Care in Geriatric Hospitals vol.44, pp.3, 2016, https://doi.org/10.21032/jhis.2019.44.3.253
  13. Effects of Awareness to Well-dying, Knowledge and Attitudes toward Advance-directives on Attitude toward End-of-life Care in Nursing Students vol.22, pp.2, 2019, https://doi.org/10.7587/kjrehn.2019.104
  14. 요양병원간호사의 죽음인식, 임종간호스트레스와 임종간호수행간의 관계 조사 vol.23, pp.1, 2016, https://doi.org/10.14695/kjsos.2020.23.1.79
  15. 요양병원 간호사의 임종간호 대처 경험 vol.21, pp.1, 2016, https://doi.org/10.5392/jkca.2021.21.01.710
  16. 임상간호사의 임종간호수행 구조모형 vol.14, pp.1, 2021, https://doi.org/10.34250/jkccn.2021.14.1.1
  17. 중환자실 간호사의 생애말 간호수행에 미치는 영향요인 vol.7, pp.3, 2021, https://doi.org/10.17703/jcct.2020.7.3.135
  18. Moderating Effect of Nurse’s Character on the Relationship between Attitudes toward Nursing Care of the Dying and Performance of Terminal Care in South Korea vol.9, pp.9, 2016, https://doi.org/10.3390/healthcare9091195