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Moral Distress and Moral Sensitivity of Nurses Working in Long Term Care Hospitals

요양병원 간호사의 도덕적 고뇌와 도덕적 민감성

  • Kim, Ji-Ah (Masan Municipal Long-term Care Hospital) ;
  • Kang, Young-Sil (College of Nursing / Institute of Health Sciences, Gyeongsang National University)
  • 김지아 (시립마산요양병원) ;
  • 강영실 (경상대학교 간호대학 / 경상대학교 건강과학연구원)
  • Received : 2018.03.16
  • Accepted : 2018.06.01
  • Published : 2018.06.30
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Abstract

This study was conducted to evaluate the moral distress, moral sensitivity, and the factors that influence moral distress and the experience of moral distress among nurse working in a long-term care hospital. Overall, 180 nurses working in long-term care hospital in G Province were evaluated. Date were collected from March 21 to April 8, 2016 and analyzed using the SPSS/WIN 23.0 program. The mean of moral distress among nurses was 3.57 and the moral sensitivity was 4.82, and these factors was significantly and positively correlated (r=0.494, p<0.001). Regression analysis revealed that the factors that significantly influenced moral distress were moral sensitivity and ethical dilemmas when conducting nursing practices. Situations that caused nurses to experience moral distress included inappropriate care behavior was not guaranteed the quality of nursing care, conditions related to unethical the human rights, conditions related to the lack of nursing staff and conditions related to the lack of support at the organizational and national level. Therefore, to reduce moral distress, nursing intervention programs that improve the moral sensitivity and ability to solve ethical-problems are needed for nurses working in long-term care facilities.

본 연구는 요양병원 간호사의 도덕적 고뇌와 도덕적 민감성의 정도, 상관관계, 도덕적 고뇌에 영향을 미치는 요인 및 도덕적 고뇌의 경험상황을 파악하기 위해 시행되었다. 연구대상자는 G도에 소재한 6개의 요양병원에 근무하는 간호사 180명으로, 자료수집은 2016년 3월 21일부터 4월 8일까지 시행하였으며 SPSS win 23.0 프로그램을 이용하여 분석하였다. 대상자의 도덕적 고뇌정도는 평균 3.57점, 도덕적 민감성정도는 평균 4.82점이었으며, 도덕적 고뇌와 도덕적 민감성 간에는 유의한 정적 상관(r=.494, p<.001)이 있었다. 요양병원 간호사의 도덕적 고뇌에 영향을 주는 변인은 도덕적 민감성과 윤리적 딜레마 경험여부로 나타났다. 대상자의 도덕적 고뇌 상황 경험은 간호의 질이 보장되지 않은 부적절한 간호행위와 관련된 상황, 비윤리적인 인권문제와 관련된 상황, 부족한 간호 인력과 관련된 상황, 조직 및 국가 차원의 지원 부족과 관련된 상황 등에서 경험한 것으로 나타났다. 따라서 요양병원 간호사의 도덕적 고뇌를 감소시키기 위해서는 도덕적 민감성과 윤리적 문제해결능력을 함께 향상시킬 수 있는 중재방안이 마련될 필요가 있다.

Keywords

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