Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Current Status of End-of-Life Care Education in Undergraduate Nursing Curriculum

간호학부 말기환자간호 교육 현황

  • Kwon, So-Hi (Research Institute of Nursing Science, College of Nursing, Kyungpook National University) ;
  • Cho, Yeon-Su (College of Nursing, Kyungpook National University)
  • 권소희 (경북대학교 간호대학 간호과학연구소) ;
  • 조연수 (경북대학교 간호대학)
  • Received : 2019.07.02
  • Accepted : 2019.11.25
  • Published : 2019.12.01
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Abstract

Purpose: The aim of this study was to analyze the current status of end-of-life (EoL) care education of the undergraduate nursing curriculum and senior students' EoL care experience and competency. Methods: A survey was conducted with 41 nursing schools and 622 senior nursing students on June 2018. The questionnaire consisted of 38 items on teaching regarding EoL care and 17 items on EoL care competencies based on the suggestions made by the American Nurses Association. Results: Only 20% among 41 nursing schools opened an EoL care course as an elective, and the course was taken by 5.1% students. Of 622 students, 70.7% witnessed death of patients during their clinical training, but 74.8% received no or little education on EoL care from their clinical training instructors. Two of 38 education contents on EoL care were taught in class for over 80% of the students. All students scored below 3 points (2.31±0.66) for all 17 competencies, which means that they cannot perform EoL care. Conclusion: This study showed that there was a serious deficiency in undergraduate nursing education on EoL care. Accordingly, most nursing students who would graduate soon considered themselves incapable of performing EoL care. Nurses experience death and dying as a part of their practice and should be prepared to provide adequate EoL care. Therefore, it is urgent to improve EoL care training in the undergraduate nursing education.

목적: 본 연구는 간호학부 교육과정에서의 말기환자간호 교육 현황을 파악하고, 졸업을 앞둔 간호대학생의 말기환자간호 학습경험과 말기환자간호 역량을 확인하기 위하여 시도되었다. 방법: 본 연구는 41개 간호학과와 해당대학 4학년 간호대학생 622명을 대상으로 한 횡단적 조사연구이다. 미국간호대학협회(AACN)에서 제시한 자료를 근거로 말기환자간호에 대한 38개 교육내용과 17가지 말기환자간호 역량으로 설문지를 구성하여 간호학과와 학생의 말기환자간호 교육내용, 학습경험, 말기환자간호 역량을 조사하였고, 기술통계와 위계적 회귀분석을 이용하여 분석하였다. 결과: 41개 간호학과 중 말기환자간호 관련 독립 교과목이 개설되어 있는 학교는 20%였고, 말기환자간호 관련 교과목을 이수한 학생은 5.1%이였다. 임상실습 중 환자의 죽음을 경험한 경우가 70.7%였으나 학생의 74.8%가 임상실습 중 실습 지도자로부터 말기환자간호에 대한 교육을 받지 못했다고 응답하였다. 말기환자간호에 대한 38개 교육내용 중 80% 이상의 학생이 이론 강의로 배웠다고 응답한 항목은 두 항목뿐이었고, 말기환자간호 17개 역량 모두가 3점 이하, 평균 2.31 (±0.66)점으로 간호학생은 말기환자간호를 수행할 수 없다고 스스로 평가하는 것으로 나타났다. 결론: 간호학부 교육의 말기환자간호 영역에 심각한 결핍이 있었다. 말기환자간호의 질을 향상시키기 위해서는 간호학과 학부과정에서 부터 체계적인 이론과 실습교육이 이루어질 수 있도록 교육과정 개선이 필요하다.

Keywords

References

  1. Statistics Korea. 2018 Life tables for Korea [Internet]. Daejeon: Statistics Korea; 2019 [cited 2019 Apr 24]. Available from: https://kostat.go.kr/portal/korea/kor_nw/1/2/1/index.board?bmode=read&aSeq=373361.
  2. Attaran A, Benton D, Chauvin J, McKee M, Percival V. Webcast the World Health Assembly. Lancet 2014;383(9912):125-6. https://doi.org/10.1016/S0140-6736(14)60023-4
  3. Jang YJ. The elderly and hospice palliative care. Health Welfare Policy Forum. 2015;225:38-47.
  4. Kwon S, Tae YS, Hong M, Choi GH. Hospice palliative nurses’ experience of caring for terminal cancer patients. Asian Oncol Nurs 2015;15:264-75. https://doi.org/10.5388/aon.2015.15.4.264
  5. Espinosa L, Young A, Symes L, Haile B, Walsh T. ICU nurses’ experiences in providing terminal care. Crit Care Nurs Q 2010;33:273-81. https://doi.org/10.1097/CNQ.0b013e3181d91424
  6. Jeon KB, Park M. Relationship of ICU nurses’ difficulties in end of life care to moral distress, burnout and job satisfaction. J Korean Acad Nurs 2019;25:42-51. https://doi.org/10.11111/jkana.2019.25.1.42
  7. Ferrell B, Mazanec P, Malloy P, Virani R. An innovative end-of-life nursing education consortium curriculum that prepares nursing students to provide primary palliative care. Nurse Educ 2018;43:242-6. https://doi.org/10.1097/NNE.0000000000000497
  8. Kim SH, Kim DH. Development and evaluation of death education program for nursing students. J Korean Acad Nurs 2015;22:277-86. https://doi.org/10.7739/jkafn.2015.22.3.277
  9. 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 Educ 2011;17:454-63. https://doi.org/10.5977/JKASNE.2011.17.3.454
  10. Kim GD. The effects of hospice unit practice education on spiritual well-being, attitude to death, and hospice awareness of nursing students. Asian Oncol Nurs 2016;16:176- 84. https://doi.org/10.5388/aon.2016.16.4.176
  11. Henoch I, Melin-Johansson C, Bergh I, Strang S, Ek K, Hammarlund K, et al. Undergraduate nursing students' attitudes and preparedness toward caring for dying persons-A longitudinal study. Nurse Educ Pract 2017;26;12-20. https://doi.org/10.1016/j.nepr.2017.06.007
  12. Ferrell B, Malloy P, Mazanec P, Virani R. CARES: AACN's new competencies and recommendations for educating undergraduate nursing students to improve palliative care. J Prof Nurs 2016;32:327-33. https://doi.org/10.1016/j.profnurs.2016.07.002
  13. Palliative Care Curriculum for Undergraduates Team. Principles for including palliative care in undergraduate curricula [Internet]. Canberra: palliative care curriculum for (PCC4U); 2012 [cited 2019 Apr 24]. Available from: http://media.pcc4u.org/Documents/Principles.pdf.
  14. Jung SY, Lee EK, Kim BH, Park JH, Han MK, Kim IK. Attitude toward death in nursing students. J Korean Acad Soc Nurs Educ 2011;17:168-77. https://doi.org/10.5977/JKASNE.2011.17.2.168
  15. Kim SH, Kim DH. Development and evaluation of death education program for nursing students. J Korean Academy Fundam Nurs 2015;22(3):277-86. https://doi.org/10.7739/jkafn.2015.22.3.277
  16. Korean Nurses Association. The present situation of educational institution [Internet]. Seoul: Korean Nurses Association; 2018 [cited 2019 Apr 24]. Available from: https://www.koreanurse.or.kr/resources/nurse_edu.php.
  17. Ministry of Government Legislation. Act on hospice & palliative care and dying patient's determination of life-sustaining treatment [Internet]. Sejong: Ministry of Government Legislation; 2019 [cited 2019 Jun 3]. Available from: http://www.law.go.kr/lsInfoP.do?lsiSeq=208190#0000.
  18. Korean Accreditation Board of Nursing Education. Korean advanced practice nurse annual report [Internet]. Seoul: Korean Accreditation Board of Nursing Education; 2016 [cited 2019 Jun 3]. Available from: http://www.kabone.or.kr/HyAdmin/view.php?&ss[sc]=1&ss[kw]=%BA%B8%B0%ED&bbs_id=kab01&page=&doc_num=561.
  19. Hui D, Bruera E. Models of integration of oncology and palliative care. Ann Palliat Med 2015;4:89-98.
  20. Palliative Care Nurses New Zealand. A national professional development framework for palliative care nursing practice in Aotearoa New Zealand [Internet]. Wellington: Ministry of Health; 2014 [cited 2019 Jun 3]. Available from: https://www.health.govt.nz/system/files/documents/publications/national-professional-development-framework-palliative-care-nursing-practice-nz-oct14.pdf.
  21. Kim GD. The effects of hospice unit practice education on spiritual well-being, attitude to death, and hospice awareness of nursing students. Asian Oncol Nurs 2016;16:176-84. https://doi.org/10.5388/aon.2016.16.4.176
  22. Jeffers S. Nurse faculty perceptions of end-of-life education in the clinical setting: a phenomenological perspective. Nurs Educ Pract 2014;14:455-515. https://doi.org/10.1016/j.nepr.2014.03.009
  23. Dame L, Hoebeke R. Effects of a simulation exercise on nursing students’ end-of-life care attitudes. J Nurs Educ 2016;55:701-5. https://doi.org/10.3928/01484834-20161114-07
  24. Kim SH, Ham YS. A meta-analysis of the effect of simulation based education: Korean nurses and nursing students. J Korean Acad Soc Nurs Educ 2015;21:308-19. https://doi.org/10.5977/JKASNE.2015.21.3.308
  25. Noh JH, Eom JY, Yang, KS, Park HS. New nurses’ experience on care of dying patients. J Qual Res 2009;10:51-62.
  26. Park HS, Jee Y, Kim SH, Kim YJ. Nursing student’s first clinical experience of death. Korean J Hosp Palliat Care 2014;17:161-9. https://doi.org/10.14475/kjhpc.2014.17.3.161
  27. Rietze LL, Tschanz CL, Richardson HRL. Evaluating an initiative to promote entry-level competence in palliative and end-of-life care for registered nurses in Canada. J Hosp Palliat Nurs 2018;20:568-74. https://doi.org/10.1097/NJH.0000000000000502
  28. Ramjan JM, Costa CM, Hickman LD, Kearns M, Phillips JL. Integrating palliative care content into a new undergraduate nursing curriculum: the University of Notre Dame, Australia-Sydney experience. Collegian 2010;17:85-91. https://doi.org/10.1016/j.colegn.2010.04.009
  29. American Association of Colleges of Nursing. End of life nursing education consortium (ELNEC) [Internet]. Washington: American Association of Colleges of Nursing; 2019 [cited 2019 Apr 24]. Available from: https://www.aacnnursing.org/ELNEC.
  30. Kim MW, Park JM, Han AG. Analysis of curriculum of 4-year nursing schools. J Korean Acad Soc Nurs Educ 2011;17:414-23. https://doi.org/10.5977/JKASNE.2011.17.3.414

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