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Difficulties in End-of-Life Care and Educational Needs of Intensive Care Unit Nurses: A Mixed Methods Study

중환자실 간호사의 임종간호 어려움과 임종간호 교육요구 조사: 혼합연구방법

  • 김현숙 (세브란스병원 간호국) ;
  • 최은경 (연세대학교 간호대학 & 김모임 간호학 연구소) ;
  • 김태희 (세브란스병원 간호국) ;
  • 윤혜영 (세브란스병원 간호국) ;
  • 김은지 (세브란스병원 간호국) ;
  • 홍진주 (세브란스병원 간호국) ;
  • 홍정아 (세브란스병원 간호국) ;
  • 김건아 (세브란스병원 간호국) ;
  • 김성하 (세브란스병원 간호국)
  • Received : 2019.02.21
  • Accepted : 2019.05.17
  • Published : 2019.06.01

Abstract

Purpose: This study aimed to identify the difficulties with end-of-life care (EOLC) experienced by intensive care unit (ICU) nurses and to investigate their educational needs for EOLC. Methods: Mixed methods were used to survey ICU nurses at a university hospital. Quantitative data (N=106) were collected through a questionnaire and analyzed using an independent samples t-test, ANOVA, Mann-Whitney U test and $Scheff{\acute{e}}$ test. Qualitative data (N=19) were collected through focus group interviews and analyzed through qualitative content analysis. Results: The mean score on the difficulty of EOLC was 3.41 out of 5. The education needs derived from the qualitative analysis was categorized into four themes: 1) guidelines on professional EOLC, 2) spiritual care, 3) a program to take care of feelings of patients, families and nurses, and 4) activities to think about death. Conclusion: This study confirmed that ICU nurses were experiencing an extreme difficulty in providing EOLC. In addition, a qualitative analysis confirmed that they needed an EOL nursing program. To mitigate the difficulties experienced by nurses involved in EOLC, there is an urgent need to develop an education program for EOLC tailored to nurses' needs.

목적: 중환자실 간호사가 경험하는 임종간호 어려움에 대해 확인하고 임종 간호 시 필요한 교육요구도를 확인하기 위한 혼합연구이다. 방법: 대상자는 중환자실에 근무하는 간호사로 106명은 설문지를, 19명은 초점집단인터뷰로 연구가 진행되었다. 자료분석은 SPSS win 23 프로그램을 이용, 서술 통계, Independent t-test, ANOVA, Mann-Whitney U test, $scheff{\acute{e}}$ test 이용하여 분석, 초점집단인터뷰는 내용 분석 방법을 사용하였다. 결과: 중환자실 간호사는 임종간호에 대해 업무적, 심리적으로 어려움을 느끼고 있었으며, 임종간호에 대한 체계적인 교육에 대한 요구와 일부 요구된 교육 내용을 확인하였다. 결론: 이러한 결과를 바탕으로 만들어진 임종간호 교육프로그램을 통하여 중환자실 간호사의 임종간호의 어려움을 감소시키고, 나아가 환자 및 보호자가 중환자실에서 평화로운 임종기를 보내는데 도움이 되었으면 한다.

Keywords

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