Journal of East-West Nursing Research (동서간호학연구지)

East-west Nursing Research Institute, Kyung Hee University (경희대학교 동서간호학연구소)
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Regional Public Hospital Nurses' Awareness of Biomedical Ethics and Attitude toward Discon-tinuing Life-Sustaining Treatment: Focusing on the Mediating Effect of Moral Sensitivity

지방의료원 간호사의 생명의료윤리의식과 연명의료중단태도: 도덕적 민감성의 매개효과를 중심으로

  • Shin, Ha Neul (Department of Nursing, Gangneung-Wonju National University) ;
  • Kim, Eun Joo (Department of Nursing, Gangneung-Wonju National University) ;
  • Kim, Geun Myun (Department of Nursing, Gangneung-Wonju National University) ;
  • Chang, Soo Jung (Department of Nursing, Gangneung-Wonju National University)
  • 신하늘 (국립강릉원주대학교 간호학과) ;
  • 김은주 (국립강릉원주대학교 간호학과) ;
  • 김근면 (국립강릉원주대학교 간호학과) ;
  • 장수정 (국립강릉원주대학교 간호학과)
  • Received : 2024.09.27
  • Accepted : 2024.10.10
  • Published : 2024.11.30
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Abstract

Purpose: This study is a descriptive survey aimed at examining the mediating effect of moral sensitivity on the awareness of biomedical ethics and attitudes toward discontinuing life-sustaining treatment among nurses in regional public hospital. Methods: Data was collected from 199 nurses working at 8 regional medical centers across the country from March 21 to April 20, 2024. The data was analyzed using SPSS/WIN 28.0 with descriptive statistics, independent t-tests, one-way ANOVA, Pearson correlation coefficients, hierarchical multiple regression analysis, and bootstrap to test for testing mediating effects. Results: Biomedical ethics awareness and attitudes toward discontinuing life-sustaining treatment showed a positive correlation. We found positive correlations between biomedical ethics awareness and moral sensitivity and attitudes toward discontinuing life-sustaining treatment and moral sensitivity. Conclusions: The study suggests that improving the moral sensitivity of regional public hospital nurses through targeted education and strategies can enhance their awareness of biomedical ethics and attitudes toward discontinuing life-sustaining treatment.

Keywords

References

  1. Je NJ, Hwa JS. Factors influencing discontinuation of life-sustaining treatment among workers at tertiary general hospitals - Knowledge and attitude toward organ donation and transplantation, awareness of death, and knowledge and awareness of hospice palliative care. Korean Journal of Hospice and Palliative Care. 2018;21(3):92-103. https://doi.org/10.14475/kjhpc.2018.21.3.92
  2. Statistical Office. https://kostat.go.kr/ansk/
  3. Oh SY. Well-being, well-dying and welfare. Journal of the Korean Entertainment Industry Society. 2016;8(1):11-31.
  4. National Life Sustaining Medical Management Institute. https://www.lst.go.kr/main/main.do
  5. Kim JS. Effects of development and operation of an advance directive for life-sustaining treatment education program for nursing students. Korean Data Analysis Society. 2019;21(4):2131-49. https://doi.org/10.37727/jkdas.2019.21.4.2131
  6. Silen M, Svantesson M, Ahlstrom G. Nurses' conceptions of decision making concerning life-sustaining treatment. Nursing Ethics. 2008;15(2): 160-73. https://doi.org/10.1177/0969733007086014
  7. Kim JH. The supreme decision on the withdrawal of life sustaining treatment: 'Madam Kim' case reviewed by the life sustaining treatment determination act. The Korean Society of Law and Medicine. 2017;17(2): 257-79.
  8. Grammatis V, Kouroutzis I, Apostolidi N, Vako I. Apostolidi T, Roka V, et al. Moral distress and moral sensitivity and their correlation with safe nursing care. Medical Research Archives. 2024;12(1):1-20. https://doi.org/10.18103/mra.v12i1.4930
  9. Lim MH. The impact of nursing students' moral sensitivity and critical thinking tendency on ethical decision-making confidence. Journal of the Korean Society of Industrial-Academic Technology. 2016;17(9):610-8. https://doi.org/10.5762/KAIS.2016.17.9.610
  10. Park EH, Kim NY. The influence of nursing professionalism, attitudes toward advance directive, and death anxiety on terminal care performance of nurses in long-term care hospitals. The Journal of Korean Academic Society of Adult Nursing. 2018;30(2):183-93. https://doi.org/10.7475/kjan.2018.30.2.183
  11. Lee JS, Ahn SH. The impact of moral sensitivity and moral distress on end-of-life care performance among intensive care unit nurses. Korean Journal of Medical Ethics. 2019;22(2):140-60. https://doi.org/10.35301/ksme.2019.22.2.140
  12. Choi SY, Kim KH. The influence of moral sensitivity, prior knowledge of life-sustaining treatment, and good perception of death on general hospital nurses' attitudes toward discontinuing life-sustaining treatment. Journal of Rehabilitation Nursing. 2020;23(2):120-31. https://doi.org/10.7587/kjrehn.2020.120
  13. Kim GM, Kim EJ, Seong KS. Nursing students' awareness of biomedical ethics and attitudes toward discontinuation of life-sustaining treatment. Child Health Nursing Research. 2017;23(3):292-9. https://doi.org/10.4094/chnr.2017.23.3.292
  14. Notification of local public institutions. https://rhs.mohw.go.kr/
  15. Kim EA, Kim NY. The mediating effect of biomedical ethics awareness in the relationship between moral sensitivity and ethical decision-making confidence in nursing students. Journal of Nursing Administration. 2020; 26(5):511-20. https://doi.org/10.11111/jkana.2020.26.5.511
  16. Kwon SJ. A study on the consciousness of biomedical ethics of the nursing students and medical students [Unpublished master's thesis]. Daegu: Keimyung University: 2003. pp.1-50.
  17. Byun EK, Choi HR, Choi AL, Kim NM, Hong KH, Kim HS. An investigative research on the attitudes of intensive care unit nurses and families on terminating life support. Clinical Nursing Research. 2003;9(1):112-24.
  18. Han SS, Kim J, Kim YS, Ahn S. Validation of a Korean version of the moral sensitivity questionnaire. Nursing Ethics. 2010;17(1):99-105. https://doi.org/10.1177/0969733009349993
  19. Shim HY. The impact of intensive care unit nurses' biomedical ethics awareness and nurse role awareness on attitudes toward discontinuing life-sustaining treatment [Master's thesis]. Ulsan: Ulsan University: 2018. pp.1-42.
  20. Lee EJ. The influence of general hospital nurses' knowledge of advance directives for life-sustaining treatment, perception of a good death, and nursing professionalism on attitudes toward discontinuation of life-sustaining treatment. [Master's thesis]. Chungju: Korea National University of Transportation: 2020. pp.1-72.
  21. Choi JY, Son YJ, Lee KH. Attitudes, perceptions, and experiences toward end-of-life care decision-making among intensive care unit nurses in Korea: An integrative review. Journal of Korean Critical Care Nursing. 2020;13(1):27-43. https://doi.org/10.34250/jkccn.2020.13.1.27
  22. Gong BH. Biomedical ethics and nursing. Journal of Central Nursing. 2001;5(1):79-88.
  23. Min JH, Kim SH. Effects of attitude toward withdrawal of life-sustaining treatment, role perception, and nursing professionalism on terminal care performance among intensive care unit nurses. Journal of the Korean Society of Industrial-Academic Technology. 2024;25(4):466-77. https://doi.org/10.5762/KAIS.2024.25.4.466
  24. Kim MJ, Nam GB. The impact of clinical nurses' attitudes and role perceptions toward withdrawal of life-sustaining treatment on nursing burnout. Journal of The Korean Data Analysis Society. 2023;25(6): 2353-70. https://doi.org/10.37727/jkdas.2023.25.6.2353
  25. Lee YJ, Lee JE. The influence of hospital nurses' moral sensitivity and ethical values on their biomedical ethics awareness. The Journal of Korean Academic Society of Nursing Education. 2023;29(1):51-9. https://doi.org/10.5977/jkasne.2023.29.1.51
  26. Kim OH, Ahn SA, Oh SM, Gong GH, Choi HO. The mediating effect of biomedical ethics awareness in the relationship between moral sensitivity and moral distress of hospital nurses. Journal of Convergence Information. 2019;9(9):78-86. https://doi.org/10.22156/CS4SMB.2019.9.9.078
  27. Kim HS, Kim KA. Effects of perception of death, consciousness of biomedical ethics, and moral sensitivity on the attitude toward advance directives of clinical nurses. Health and Nursing. 2020;32(2):29-38. https://doi.org/10.29402/HN32.1.4
  28. Hwang GH, Shin JM, Kim MS, Kim SH, Yang SH. The impact of moral sensitivity and moral distress on the caring behavior of neonatal and pediatric intensive care unit nurses. Journal of Korean Medical Ethics. 2022;25(3):261-76. https://doi.org/10.35301/ksme.2022.25.3.261
  29. Kim KA, Jeong GS. The effect of biomedical ethics education on nursing students' moral sensitivity, critical thinking tendency, and biomedical ethics awareness. Journal of the Korean Society of Industrial Academic Technology. 2019;20(2):240-9. https://doi.org/10.5762/KAIS.2019.20.2.240
  30. Jang MO, Chung KH. A Study on the effect of small and medium-sized hospital nurses' nursing professionalism and biomedical ethics on their confidence in ethical decision-making. Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology. 2019;9(11): 743-55. http://doi.org/10.35873/ajmahs.2019.9.11.067