Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Hospice-Palliative Care Nurses' Knowledge of Delirium, Self-Efficacy and Nursing Performance on Delirium

호스피스완화 간호사의 섬망 관련 지식, 자기효능감 및 간호수행도의 관계

  • Jang, Bo-Jung (Department of Nursing, Bundang Jesaeng General Hospital) ;
  • Yeom, Hye-Ah (College of Nursing, The Catholic University of Korea)
  • Received : 2018.03.28
  • Accepted : 2018.05.18
  • Published : 2018.06.01
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Abstract

Purpose: The aim of this study is to examine the relationships among hospice-palliative care (HPC) nurses' knowledge of delirium, self-efficacy and nursing performance. Methods: This study was participated by 174 nurses working in the HPC unit. The nurses were asked to fill out a questionnaire that was structured to measure their knowledge of delirium, a self-efficacy in clinical performance scale (SECPS) and nursing performance. Results: The mean score for knowledge was 32.83 out of 45, with correction rate of 73%. The mean score for self-efficacy was 7.08 out of 10. The mean score of nursing performance was 2.95 out of 4. Significant correlation was observed among the variables of knowledge (r=0.28, P<0.001), self-efficacy (r=0.51, P<0.001) and nursing performance. Conclusion: Nurses with high level of knowledge of delirium showed high level of self-efficacy, and consequently better HPC nursing performance. It is necessary to develop a training program on delirium considering nurses' needs of knowledge of the condition. The effectiveness of the training program should be also examined in future.

목적: 호스피스완화 간호사의 섬망에 대한 지식, 자기효능감 및 간호수행도 간의 관계를 파악하기 위함이다. 방법: 전국 19개 호스피스 완화의료 센터에 근무하는 간호사 174명을 대상으로 구조화된 설문지를 이용하였다. 결과: 첫째, 호스피스완화 간호사의 섬망에 대한 지식 정도는 45점 만점 중 평균 32.83점으로 73%의 정답률을 보였다. 섬망에 대한 지식은 4년제 대학 졸업 이하 군, 종교가 없는 군, 호스피스 경력이 59개월 미만 군에서 유의하게 낮았다. 둘째, 호스피스완화 간호사의 자기효능감 정도는 10점 만점 중 평균 7.08점이었다. 하위영역에서는 간호중재에 대한 자기효능감이 7.36점으로 가장 높았고, 간호사정에 대한 자기효능감이 6.79점으로 가장 낮았다. 자기효능감은 40세 이하, 미혼, 4년제 대학 졸업 군, 종교가 없는 군, 일반간호사 군, 임상경력이 120개월 미만 군과 호스피스 경력이 59개월 미만 군, 가족의 생애말기 돌봄 경험이 없는 군에서 유의하게 낮았다. 셋째, 호스피스 완화 간호사의 섬망에 대한 간호수행도는 4점 만점에 평균 2.95점이었다. 간호수행도는 23~29세, 미혼, 4년제 대학 졸업 군, 종교가 없는 군, 임상경력이 59개월 미만 군, 호스피스 경력이 낮은 군, 가족의 생애말기 돌봄 경험이 없는 군에서 유의하게 낮았다. 넷째, 섬망에 대한 간호수행도는 지식(r=0.28) 및 자기효능감(r=0.51)과 양의 상관관계를 보였다. 또한 지식은 자기효능감과 양의 상관관계를 나타내었다(r=0.24). 결론: 호스피스완화 간호사의 섬망에 대한 지식과 자기효능감, 간호수행도는 비교적 양호한 편으로 나타났지만 4년제 대학 졸업 이하군과 종교가 없는 군, 호스피스 경력이 5년 미만 군에서는 낮았다. 따라서 호스피스완화 간호에서 섬망 간호의 질적 향상을 위해서는 간호사의 지식 정도 및 요구를 선택적으로 반영한 양질의 섬망 교육프로그램을 개발하고 적용하여야 하며 섬망 간호 지식 및 수행도가 낮은 집단에 대한 중재전략 개발을 위한 연구가 필요할 것으로 사료된다.

Keywords

References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington, DC:American Psychiatric Assoc;2013. p. 596-602.
  2. Jacqeline FC, Carol OL. Delirium: Opportunity for comfort in palliative care. J Hosp Palliat Nurs 2012;14:386-94. https://doi.org/10.1097/NJH.0b013e31825d2b0a
  3. Centeno C, Sanz A, Bruera E. Delirium in advanced cancer patients. Palliat Med 2004;18:184-94. https://doi.org/10.1191/0269216304pm879oa
  4. Irwin SA, Rao S, Bower KA, Palica J, Rao SS, Maglione JE, et al. Psychiatric issues in palliative care: recognition of delirium in patients enrolled in hospice care. Palliat Support Care 2008;6:159-64.
  5. Raymond WKW. Delirium in palliative care setting. Newsletter of HKSPM 2009;1:29-32.
  6. Breitbart W, Alici Y. Agitation and delirium at the end of life: "We couldn't manage him". JAMA 2008;300:2898-910, E1. https://doi.org/10.1001/jama.2008.885
  7. Milisen K, Brase T, Fick DM, Foremann MD. Cognitive assessment and differentiating the 3 Ds (dementia, depression, delirium). Nurs Clin North Am 2006;41:1-22, v. https://doi.org/10.1016/j.cnur.2005.09.001
  8. Rao S, Ferris FD, Irwin SA. Ease of screening for depression and delirium in patients enrolled in inpatient hospice care. J Palliat Med 2011;14: 275-9. https://doi.org/10.1089/jpm.2010.0179
  9. Morandi A, Davis D, Taylor JK, Bellelli G, Olofsson B, Kreisel S, et al. Consensus and variations in opinions on delirium care: a survey of Euro- pean delirium specialists. Int Psychogeriatr 2013;25:2067-75. https://doi.org/10.1017/S1041610213001415
  10. Hui D, De La Cruz M, Bruera E. Palliative care for delirium in patients in the last weeks of life: the final frontier. J Palliat Care 2014;30:259-64.
  11. Cynthia LC. Refractory delirium in a hospice patient: A case study. J Hosp Palliat Nurs 2015;17:98-102. https://doi.org/10.1097/NJH.0000000000000112
  12. Park YS, Kim KS, Song KJ, Kang J. A preliminary survey of nurses' understanding of delirium and their need for delirium education - in a uni- versity hospital -. J Korean Acad Nurs 2006;36:1183-92. https://doi.org/10.4040/jkan.2006.36.7.1183
  13. Grace CO, Carrie B, Ronald P. Nurses' assessment of delirium with underlying dementia in end-of-life care. J Hosp Palliat Nurs 2015;17:16-21. https://doi.org/10.1097/NJH.0000000000000099
  14. Bandura A. The explanatory and predictive scope of self-efficacy theory. JSCP 1986;4:359-73. https://doi.org/10.1521/jscp.1986.4.3.359
  15. Cheraghi F, Hassani P, Yaghmaei F, Alavi-Majed H. Developing a valid and reliable self-efficacy in clinical performance scale. Int Nurs Rev 2009;56:214-21. https://doi.org/10.1111/j.1466-7657.2008.00685.x
  16. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 1977;84:191-215. https://doi.org/10.1037/0033-295X.84.2.191
  17. Lee TW, Ko YK. Effects of self-efficacy, affectivity and collective efficacy on nursing performance of hospital nurses. J Adv Nurs 2010;66: 839-48. https://doi.org/10.1111/j.1365-2648.2009.05244.x
  18. Park JW, Kim CJ, Kim YS, Yoo MS, Yoo H, Chae SM, et al. Impact of critical thinking disposition, general self-efficacy, and leadership on clini- cal competence in nursing students. Korean J Med Educ 2012;24:223-31. https://doi.org/10.3946/kjme.2012.24.3.223
  19. Johnson A, Hong H, Groth M, Parker SK. Learning and development: promoting nurses’ performance and work attitudes. J Adv Nurs 2011; 67:609-20. https://doi.org/10.1111/j.1365-2648.2010.05487.x
  20. Lee SL. The Effect of knowledge and self-efficacy on hospital nurses nursing performance regarding oxygen therapy [master's thesis]. Seoul: Seoul National Univ.; 2013. Korean.
  21. Park J, Park JW. Effects of a delirium education program for nurses on knowledge of delirium, importance of nursing intervention and nursing practice. J Korean Acad Soc Home Care Nurs 2013;20:152-9.
  22. Suh HJ, Yoo YS. Intensive Care Unit nurse's knowledge, nursing performance, and stress about delirium. Korean J Adult Nurs 2007 Mar;19: 55-65.
  23. Lim EY. An exploratory study of staff nurse's knowledge and experience of delirium in the pediatric Intensive Care Unit [master thesis]. Seoul: Catholic Univ.; 2015. Korean.
  24. Kim MJ, Lee HJ. The effects of delirium care training program for nurses in hospital nursing units. Korean J Adult Nurs 2014;26:489-99. https://doi.org/10.7475/kjan.2014.26.5.489
  25. Park SJ. Knowledge and practices about delirium in general hospital nurses [master thesis]. Jeonju: Chonbuk National Univ.; 2011. Korean.
  26. Park YS, Gu MO. The development and effects of evidence-based nursing practice guideline for cancer patients with delirium. Evid Nurs 2013:1:4-15.
  27. Kim MY, Eun Y. Knowledge, performance and stress about care for delirium in orthopedic hospital nurses. J Muscle Jt Health 2013;20:72-80. https://doi.org/10.5953/JMJH.2013.20.1.72
  28. Jung IA, Jung DY. Recovery room nurses' knowledge and stress of emergence delirium. J Korean Clin Nurs Res 2014;20:256-66.
  29. Yang YH. Comprehension and knowledge about delirium in nurses working at long-term care hospitals or general hospitals. J Korean Acad Soc Nurs Edu 2010;16:312-20. https://doi.org/10.5977/JKASNE.2010.16.2.312
  30. Pfister D, Markett S, Muller M, Muller S, Grutzner F, Rolke R, et al. German nursing home professionals' knowledge and specific self-efficacy related to palliative care. J Palliat Med 2013;16:794-8. https://doi.org/10.1089/jpm.2012.0586
  31. Oh JM. The association of knowledge on delirium with nursing performance and educational needs [master thesis]. Seoul: Catholic Univ.; 2015. Korean.
  32. Meyer-Massetti C, Cheng CM, Sharpe BA, Meier CR, Guglielmo BJ. The FDA extended warning for intravenous haloperidol and torsades de pointes: how should institutions respond? J Hosp Med 2010;5:E8-16.
  33. Nice.org [Internet]. Delirium: prevention, diagnosis and management clinical guideline. London: The National Institute for Health and Care Excellence; c2010 [cited 2015 Jan 10]. Available from: http://www.nice.org.uk/guidance/cg103.

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