This study aimed to explore predictors of terminal care stress of nurses. Participants were 197 nurses from a C university hospital in J city. Data were analyzed with descriptive statistics, independent t-test, one-way ANOVA, pearson's correlation coefficient and stepwise multiple regression. On hierarchial multiple regression, dignified dying attitude, turnover intention, well dying attitude, and spirituality explained 39.6% of variance in terminal care stress. The results suggest that dignified dying attitude, well dying attitude, spirituality need to be properly assessed and managed to reduce terminal care stress of nurses.
Purpose: This study was conducted to explore the effects of attitude to death in hospice and palliative professionals on their terminal care stress, and to analyze relationships among variables related to the two aforementioned parameters, such as depression and coping strategies. Methods: Participants were 131 hospice and palliative professionals from the cancer units of two tertiary hospitals and two general hospitals, two hospice facilities, two geriatric hospitals, and two convalescent hospitals in J province. Data were collected from April through June 2015 and analyzed using t-test, factor analysis, ANOVA ($Scheff{\acute{e}}$ test), ANCOVA, and Pearson's correlation and a path analysis using the SPSS/WIN 21.0 and AMOS 18.0 programs. Results: The score for attitude to death was low (2.63), and that for depression was 0.45. Among all, 16.0% of the participants showed need for depression management. They scored 3.82 on terminal care stress. The subcategory with the highest mark was inner conflicts on limitation given availability of medical services (4.04). The score on coping strategy was low (3.13). They used passive coping strategies such as interpersonal avoidance (4.03), fulfilling basic needs (3.65) such as sleeping or eating. Attitudes to death had a direct negative effect on the terminal care stress level and indirectly affected through depression and fulfilling basic needs (CS2). Conclusion: It is necessary to provide hospice and palliative professionals with education on death and dying, as well as access to programs that provide emotional support and promote positive cognition of death and dying.
Purpose. The purpose of this study was to investigate knowledge, stress and nursing performance about care for delirium in geriatric hospital nurses. Methods. For this study, data were collected from 242 nurses employed at geriatric hospitals with the capacity of more than 100 beds which were located in A, P and Y cites. Frequency analysis, t-test and one-way ANOVA were utilized to analyze the data and Scheffe test was used to conduct post-hoc tests. Results. Nurses showed significant differences in the level of Knowledge, as well as terminal care performance by marital status, nursing experience. A significant relationship was found between knowledge, stress and Delirium care performance. Conclusion. This study found nurses perform delirium care with a high level of stress but with insuffiecient understanding, and thus, showed great needs for related training. Such findings can be useful to develop educational programs to improve knowledge on delirium and plans to reduce stress from delirium for geriatric hospital nurses.
Purpose: This study investigated the effects that music therapy by self-selected music listening has on the affect and stress relief in adult patients who have been diagnosed with terminal cancer by pain level. Methods: Participants were 20 terminally ill cancer patients who were over 18 years old and were admitted to the hospice and palliative care unit of a local hospital. At the beginning of each session, participants selected music of their choice. Each participant had a total of six 30-minute music listening sessions. Participants were grouped into two according to their self-rated perceived pain scores on the visual analogue scale and numeric rated score: 5 and above and less than 5. Each participant completed a questionnaire on their affect state before and after each session and a questionnaire on their stress level before the first session and after the last session. Further analysis was performed to compare differences between the two groups according to pain level. Results: There were significant differences in patients' affect before and after each session (P<0.001) and stress level before and after the therapy (P=0.001). Conclusion: In this study, self-selected music listening had positive effects on terminal cancer patients' affect and stress regardless of perceived pain level. Therefore, self-selected music listening can be used as an appropriate intervention to improve affect and reduce stress in terminal cancer patients in the hospice and palliative care unit.
Purpose: This descriptive study aimed to explore nursing workplace spirituality, end-of-life care stress, and resilience as factors influencing compassion fatigue among nurses working in hospice and palliative care units. Methods: Data were collected using a self-report questionnaire completed by 146 nurses at 14 hospice and palliative care institutions across South Korea who had worked in a hospice and palliative care institution for at least 6 months and had experience providing end-of-life care. Data were collected from February 25, 2019 to April 12, 2019, and analyzed using SPSS for Windows version 18.0. As appropriate, descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and stepwise multiple regression were used. Results: The survey results showed that factors influencing compassion fatigue were resilience, subjective health status, current satisfaction with the hospice ward, and end-of-life care stress. Higher levels of resilience, a subjective health status of "healthy", high levels of current satisfaction with the hospice ward, and lower levels of end-of-life care stress were associated with lower levels of compassion fatigue, explaining 42.9% of the total variance. Conclusion: The results of this study suggest that resilience is an important factor mitigating compassion fatigue among nurses at hospice and palliative care institutions. Therefore, intervention programs should be developed to reduce compassion fatigue.
Purpose: The purpose of this study was to investigate the influence of perceptions of death, end-of-life (EOL) care stress, and emotional intelligence on attitudes toward EOL care among nurses in the neonatal intensive care unit (NICU). Methods: The participants were 111 nurses working in a NICU who had experienced EOL care at least once. Data were analyzed using the t-test, Pearson correlation coefficient, and stepwise multiple regression analysis in SPSS for Windows. Results: The mean score for perceptions of death was 3.16 out of 5, the mean score for EOL care stress was 3.61 out of 5, the mean emotional intelligence score was 4.66 out of 7, and the average score for EOL care attitudes was 2.77 out of 4. The factors affecting attitudes towards EOL care were academic degree, anxiety regarding death, negativity towards death, experiences of patient death, and emotional intelligence. The explanatory power of these variables for attitudes towards EOL care was 24.7%. Conclusion: The results of this study are expected to serve as a basic reference for the development of nursing education programs and EOL care protocols to improve attitudes toward EOL care among NICU nurses.
Purpose: This study aimed to provide basic data for developing interventions to relieve the end-of-life care stress experienced by pediatric nurses by examining the relationships of end-of-life care stress with compassionate competence and attitudes toward end-of-life care. Methods: Data were collected via a survey that was conducted from September 10 to September 30, 2018 and administered to 113 nurses who had worked for more than 6 months in a pediatric unit at a tertiary hospital in Seoul, South Korea. The data were analyzed for frequency, percentage, mean, and standard deviation, and the independent t-test, one-way analysis of variance, and Pearson correlation analysis were conducted using SPSS version 25.0. Results: End-of-life care stress among pediatric nurses had a weak positive correlation (r=0.216, P<0.05) with compassionate competence and had no significant correlation with attitudes toward end-of-life care. Among the sub-factors of end-of-life care stress, psychological difficulties had a weak positive correlation with sensitivity (r=0.309, P<0.01) and communication (r=0.230, P<0.05), which are aspects of compassionate competence. Lack of knowledge about end-of-life care had a weak positive correlation with communication (r=0.209, P<0.05) as an aspect of compassionate competence. Conclusion: To improve the quality of end-of-life care provided by pediatric nurses, it is necessary to improve their compassionate competence and reduce their end-of-life care stress by developing education and support programs tailored to the characteristics of children and specific communication methods.
The purpose of this study is to identify factors affecting the stress of End-of-life care in long-term care hospitals and to identify perception and education requirement of End-of-life care. The subjects of this study were 163 nurses who had worked at seven long-term care hospitals in Gyeongsangnam-do for more than six months and had more than one end-of-life care experience. They agreed to participate in the study using structured questionnaires from May 27 to June 7, 2021. As a result of this study, the most influential factor for the terminal care stress of the nurses in the long-term care hospitals is the education needs of End-of-life care(β=.25, p=.001). The following factors have been identified death anxiety (β=.21, p=.005), satisfaction with the End-of-life care environment (β=.17, p=.017), and End-of-life care perception(β=-.15, p=.040). Based on the results of this study, it is necessary to meet the educational needs of the End-of-life care for the nurses in the long-term care hospitals in order to relieve their stress. For this, it is necessary to develop and apply educational programs for End-of-life care.
Purpose: This study aimed to understand the mechanisms of decision regret and stress of family surrogates' end-of-life decision making using an exploratory path model. In particular, the research identified the direct effects of perceptions of uncertainty and effective decisions on decision regret and stress, and examined the indirect effects of being informed, having clear values, and being supported for decision regret and the stress of end-of-life decision making through the mediating variables of perceptions of uncertainty and effective decisions. Methods: Data were collected from 102 family surrogates who had participated in end-of-life decision making for patients with terminal cancer in a tertiary hospital. Results: Perception of effective decisions was a significant direct predictor of decision regret, and uncertainty was a significant predictor of stress among the participants. Being informed, having clear values, and being supported had a significant indirect influence on decision regret through the perception of effective decisions among family surrogates. However, only having clear values had a significant indirect influence on stress through the perception of uncertainty. The model explained 63.0% of decision regret and 20.0% of stress among the participants and showed a good fit with the data, ${\chi}^2=12.40$ (df=8, p=.134), TLI=.97, and RMSEA=.07. Conclusion: Nurses can support family surrogates in end-of-life decision-making processes to decrease their decision regret by providing information about end-of-life care choices, clarifying personal values, and supporting the decision-making process, and to relieve their stress by facilitating the clarification of personal values.
Cancer is the second leading cause of the death in Korea. Family caregivers of dying patients manifest many psychological and physical symptoms of stress, and they often seek for informational support from health care providers. Unfortunately, however, few systematic studies identify the actual effect of such support on family caregivers. This study, thus, intends to evaluate the effect of informational support for hospice care. One group pretest-posttest design was used, employing the stress-coping model by Cohen and Wills as a conceptual framework. This research was conducted from July 1 to November 15, 1998, initially with 32 subjects sampled from hemato-oncology department of two general hospitals in Seoul, but reduced to 18 at the end due to the untimely death of patients or caregiver's refusal during the course of study. Informational supports were programmed to provide the family caregivers with 8 times of education and counseling as well as 24-hour hot-line for 4 weeks. A booklet that explains the various problems of hospice care was also prepared and distributed to all subjects. Data were collected by using self-report questionnaires and reviewing medical records. The tools used in this study were based on the Weinert's PRQ-II(scale of perceived social support), Spielberger's state anxiety inventory, and CES-D. Also included in the data collection were the general characteristics of family caregivers and patients, and the pain intensity and the performance status of patients. The data were analyzed with descriptive statistics, Wilcoxon sign rank test and paired t-test using SPSSWIN program. The results of the study were as follows: 1.The perceived social support of family caregivers was not significantly increased with informational support for hospice care(t=1.64, one tailed p=.060). 2.The anxiety of family caregivers was significantly reduced following informational support for hospice care(t=3.48, one tailed p=.002). 3.The depression of family caregivers was significantly reduced following informational support for hospice care(t=-2.18, one tailed=.022). 4.The pain intensity of patients with terminal cancer was significantly reduced following informational support for hospice care(t=-2.41, two tailed p=.027). The results suggest that the informational support provided to family caregivers of patients with terminal cancer reduced not only their anxiety and depression but also the pain intensity of patients. Further study is necessary to consolidate the conceptual framework of this study with expanded number of subjects. Nevertheless, it was certain that the informational support program for hospice care was very helpful to both caregivers and patients. Thus, the informational support program is strongly recommended for the hospitals which have no hospice unit yet.
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