DOI QR코드

DOI QR Code

Factors Affecting End-of-life Care Performance of Nurses in Hospice and Palliative Nursing Institutions

호스피스 완화의료 전문기관 간호사의 임종간호수행 영향요인

  • Received : 2024.03.05
  • Accepted : 2024.05.20
  • Published : 2024.05.28

Abstract

This study is a descriptive research study to determine the extent to which end-of-life care stress, death awareness, and prior decision-making attitudes of nurses at a hospice and palliative nursing institution have an impact on end-of-life care performance. The subjects of this study were 200 nurses working at a hospice and palliative nursing institution. Data collection for this study was conducted from August 9 to September 30, 2021, using two methods: written questionnaire and internet survey. The data analysis method used Pearson's correlation coefficient to analyze the relationship between the subjects' end-of-life care stress, death awareness, prior decision-making attitude, and end-of-life care performance. Hierarchical Regression was used to identify factors affecting the subject's end-of-life care performance. The results of this study showed a significant correlation between end-of-life care performance and death awareness (r=.22, p=.002), and end-of-life care performance and prior decision-making attitude (r=.20, p=.004). And prior decision-making attitude and death awareness had a significant impact on end-of-life care performance. As death awareness and prior decision-making attitudes increased, end-of-life care performance increased, and end-of-life care stress did not appear to be a statistically significant factor influencing end-of-life care performance. In order to improve hospice nurses' ability to provide end-of-life care, intervention that takes into account the influencing factors is required.

본 연구는 호스피스 완화의료 전문기관 간호사의 임종간호스트레스, 죽음인식, 사전의사결정 태도가 임종간호수행에 미치는 영향 정도를 규명하기 위한 서술적 조사 연구이다. 본 연구의 대상자는 보건복지부로부터 호스피스 완화의료 전문기관으로 지정된 의료기관에 근무하는 호스피스 간호사 200명이다. 본 연구의 자료수집은 서면 설문지와 인터넷 설문조사 두가지 방법을 사용하여 2021년 8월 9일부터 9월 30일까지 이루어졌다. 자료분석방법은 대상자의 임종간호스트레스, 죽음인식, 사전의사결정 태도, 임종간호수행 간의 관계를 분석하기 위해 Pearson's correlation coefficient를 사용하였고 대상자의 임종간호수행에 영향을 미치는 요인을 파악하기 위해 Hierarchical Regression을 사용하였다. 본 연구결과 임종간호수행과 죽음인식(r=.22, p=.002), 임종간호수행과 사전의사결정 태도(r=.20, p=.004)는 유의한 상관관계를 나타냈다. 그리고 독립변수를 추가한 MODEL2에서 연령, 사전의사결정 태도, 죽음인식이 유의한 임종간호수행 영향요인이었으며 이들의 설명력은 10.4%이었다(F=3.90, p<.001). 호스피스 간호사의 임종간호스행 능력을 향상시키기 위해서는 그 영향요인을 고려한 중재가 요구된다.

Keywords

References

  1. Korean Society for Hospice and Palliative Care. (2018). Hospice palliative care, Seoul : Koonja Publishing Company
  2. National care center and National hospice center. (2021). Hospice palliative care. National care center and National hospice center. https://hospice.go.kr:8444/?menuno=9
  3. S. N. Kim & S. O. Choi. (2010). Nurses' Death Anxiety and Spirituality. The Journal of Korean Academic Society of Nursing Education, 16(1), 101-110. DOI : 10.5977/JKASNE.2010.16.1.10
  4. S. I. Ji & H. S. You. (2014). Korean journal of hospice and palliative care, 17(4), 232-240. DOI : 10.14475/kjhpc.2014.17.4.232
  5. S. Y. Kwak & B. S. Lee. (2018). Role Adaptation Process of Hospice Nurses. J Korean Acad Nurs Adm. 24(2), 149-160. DOI : 10.11111/jkana.2018.24.2.149
  6. K. W. Cho & Y. J. Kim. (2013). The Impact of Nurses' Attitude toward Dignified Death and Moral Sensitivity on Their End-of-Life Care Performance. Korean journal of hospice and palliative care, 16(4), 223-231. DOI : 10.14475/kjhpc.2013.16.4.223
  7. S. H. Kwon, Y. S. Tae, M. J. Hong & K. H. Choi. (2015). Asian Oncology Nursing. 15(4), 264-275. DOI : 10.5388/aon.2015.15.4.264
  8. M. Karen, D. Andrew, C. Michael, S. William. (2010). The impact of advance care planning on end of life care in eldery patient : randomised controlled trial. BNJ. 23, 340-345. DOI : 10.1136/bmj.c1345.
  9. Y. W. Woo. K. H. Kim & K. S. Kim. (2013). Death Anxiety and Terminal Care Stress among Nurses and the Relationship to Terminal Care Performance. Korean journal of hospice and palliative care, 16(1), 33-41. DOI : 10.14475/kjhpc.2013.16.1.033
  10. Y. J. Kim, E. J. Gong, R. Y. Park, J. S. Choi, Y. W. Han, S. A. Park & S. K. Yeom. The Perception of Death and Attitudes towards Terminal Care among Nursing Students. Journal of the Korean Society for Multicultural Health. 10(1), 31-38, DOI : 10.33502/JKSMH.10.1.31
  11. G. S. Lim & Y. G. Yoo. (2023). Factors Influencing Performance of End-of-Life Care by ICU Nurses: A Descriptive Survey Study. Korean Journal of Adult Nursing, 35(1), 47-60, DOI : 10.7475/kjan.2023.35.1.47
  12. J. W. Kang & S. J. Han. (2013). A Study of Intensive Care Unit Nurses' Understanding of the Meaning of Death, Death Anxiety, Death Concern and Respect for Life. Korean journal of hospice and palliative care, 16(2), 80-89. DOI : 10.14475/kjhpc.2013.16.2.080
  13. J. S. Jung & K. S. Lee. (2020). Investigation of the Relationships Between Death Recognition, Terminal Care Stress, and Terminal Care Performance in Terminal Hospital Nurses. Science of emotion & sensibility, 23(1), 79-88. DOI : 10.14695/KJSOS.2020.23.1.79
  14. Y. K. Lee. (2017). Advanced Directive. The Hanyang Journal Of Economic Studies, 34(4), 293-318. DOI : 10.18018/HYLR.2017.34.4.293
  15. J. A. Adams, D. E. Bailey, R. A. Anderson, & S. L. Docherty. (2011). Nursing roles and strategies in end-of-life decision making in acute care: A systematic review of the literature. Nursing research and practice, 2011. DOI : 10.1155/2011/527834.
  16. E. H. Park N. Y. Kim. (2018). The influence of Nursing Professionalism, Attitudes toward Advance Directive, and Death Anxiety on Terminal Care Performance of Nurses in Long-term Care Hospitals. Korean Journal of Adult Nursing, 30(2), 183-193. DOI : 10.7475/kjan.2018.30.2.183
  17. Y. O. Lee. (2004). A study on the stress caused by end-of-life care among cancer ward nurses. Mater dissertation. Kyung Hee University, Seoul.
  18. I. Yoshiyuki & S. Y. Han. (2004). A Study on Development of a View of Life and Death Scale. Korean Journal of Psychological and Social Issues, 10(1), 31-82.
  19. M. A. Jezewski, J. Brown, Y. Wu, M. . Meeker, J. Y. Feng & X. Bu. (2005). Oncology nurses' knowledge, attitudes, and experiences regarding advance directives. Oncol Nurs Forum. 32(2), 319-27. DOI : 10.1188/05.onf.319-327.
  20. H. J. Cheon & E. H. Kim. (2019). Reliability and Validity of an Instrument Assessing Advance Directives for Nurse. Korean J Hosp Palliat Care, 22(3), 134-143. DOI : 10.14475/kjhpc.2019.22.3.134
  21. S. J. Park & S. H. Choi. (1996). A Study on the Degrees of Death Orientation and Terminal Care Performance of Nurses. Journal of Korean Academy of Fundamentals of Nursing, 3(2), 285-297.
  22. L. J. Lee & H. S. Park. (2017). Death Anxiety and Terminal Care Performance of Nurses at Long Term Care Hospitals. Korean J Hosp Palliat Care. 20(1), 37-45. DOI : 10.14475/kjhpc.2017.20.1.37
  23. E. M. Seol & K. C. Kang. (2015). Critical Care Nurses' Attitudes toward Hospice and Palliative Care and their Related Factors. Perspectives in Nursing Science. 12(2), 94-105. DOI : 10.16952/pns.2015.12.2.94
  24. Y. W. Woo, K. H. Kim & K. S. Kim. (2013). Death Anxiety and Terminal Care Stress among Nurses and the Relationship to Terminal Care Performance. Korean J Hosp Palliat Care, 16(1), 33-41. https://doi.org/10.14475/kjhpc.2013.16.1.33
  25. S. A. Kwon. (2016). Factors Influencing the Attitudes of Social Work Professionals toward Advance Care Planning. Health and Social Welfare Review. 36(4), 284-313. DOI : 10.15709/hswr.2016.36.4.284
  26. K. H. Yang & S. I. Kwon. (2015). The Effects of Attitude to Death in the Hospice and Palliative Professionals on Their Terminal Care Stress. Korean J Hosp Palliat Care. 18(4), 285-293. DOI : 10.14475/kjhpc.2015.18.4.285
  27. S. E. Kim. (2011) Relationship between intensive care unit nurses' perception of death and end-of-life care performance. Mater dissertation. Ajou University, Suwon.
  28. E. A. Cho & J. S. Kee. (2021). Effects of Perception of Good Death and Knowledge toward Advance Directive on Attitude Toward withdrawal of Life-sustaining Treatment among University Hospital Nurses. The Journal of the Korea Contents Association, 21(4), 688-698. DOI : 10.5392/JKCA.2021.21.04.688
  29. S. Y. Jung & J. H. Kim. (2019). Influence of Positive Psychological Capital and Death Awareness on Terminal Care Performance of Hematooncology Unit Nurses. Korean J Hosp Palliat Care, 22(2), 77-86. DOI : 10.14475/kjhpc.2019.22.2.77
  30. K. H. Jo, A. R. Park J. J. Lee & S. J. Choi. (2015). The Effect of Suffering Experience, Empathy Ability, Caring Behaviors on Terminal Care Performance of Clinical Nurses. Korean J Hosp Palliat Care. 18(4). 276-284. DOI : 10.14475/kjhpc.2015.18.4.276
  31. A. Brinkman-Stoppelenburg, J. A. Rietjens & A. Van der Heide. (2014). The effects of advance care planning on end-of-life care: a systematic review. Palliative medicine, 28(8), 1000-1025. DOI : 10.1177/0269216314526272.