지지적 간호행위에 대한 암환자와 간호사의 인식유형: 코오리엔테이션 모델 적용

Other Titles
The Cognitive Types of Supportive Nursing Behavior in Cancer Patients and Nurses:Application of The Coorientation Model
Authors
김은자
Abstract
Purpose: The present study was conducted to identify the cognitive types of supportive nursing behavior in cancer patients and nurses and to determine the difference between two groups on supportive nursing behaviors based on the findings. Methods: The cognitive types of supportive nursing behaviors were classified by first identifying them using Q-methodology and then using the framework of Watson’s caring behavior model. Differences in cognitive types were analyzed using COM. Results: The findings of the present study were as follows.. 1. The cognitive types of supportive nursing behaviors in cancer patients were empathic expressions, positive responses, and respect, while the cognitive types in nurses estimated by cancer patients were raising hope, demonstration of professionalism, provision of appropriate information, and response to individual needs. 2. The cognitive types of supportive nursing behaviors in nurses were friendly communication, skilled nursing, and tailored nursing, while the cognitive types in cancer patients estimated by nurses were thinking from the patient’s perspective, sincere listening, giving trust, and heartful consolation. 3. In terms of the agreement between the supportive nursing behaviors of the two groups, respecting cancer patients had a partial association with nursing skills of nurses and friendly communication of nurses, while no agreement was found for the empathic expression of cancer patients and positive responses. 4. In terms of the congruency between cancer patients’ and nurses’ cognitions, estimated by cancer patients, partial associations were found between empathic expression and increasing hope, and between respect and demonstration of professionalism. 5. In terms of congruency between nurses’ cognition and cancer patients’ cognition estimated by nurses, partial associations were found between friendly communication and sincere listening, friendly communication and thinking from the patient’s perspective, skilled nursing and thinking from the patient’s perspective, skilled nursing and sincere listening, and tailored nursing and giving trust. However, no agreement was found, for heartful consolation among cancer patient’s cognitive types estimated by nurses. 6. In terms of the accuracy between cancer patients’ cognition and cancer patients’ cognition estimated by nurses, partial associations were found between empathic expression and heartful consolation, and between respect and thinking from the patient’s perspective. 7. In terms of accuracy between nurses’ cognition and nurses’ cognition estimated by cancer patients, partial associations were found between friendly communication and provision of appropriate information, skilled nursing and tailored nursing, demonstration of professionalism and response to individual needs, and tailored nursing and response to individual needs. However, no agreement was found, for improving hope among nurses’ cognitive types estimated by cancer patients. Conclusion: Cancer patients recognized emotional and expressive nursing behaviors such as verbal behavior, nonverbal behaviors, respect for patient, and hope in the recognition of supportive nursing behavior. Differences in cognition between the two groups, however, were confirmed as nurses gave weight to listening closely, information, skilled practice, and individual nursing in supportive nursing behavior. Therefore, to overcome the differences in the perceptions of cancer patients and nurses regarding supportive nursing behaviors, it is necessary to assess patients’ needs for supportive care accurately and to provide appropriate nursing care. In addition, for supportive nursing practice, it is important that nurses express sincere sympathy about patients’ condition, respond positively, and perform patient-oriented nursing.
본 연구는 지지적 간호행위에 대한 암환자와 간호사의 인식유형을 확인하고 이를 바탕으로 지지적 간호행위에 대한 두 집단 간 인식유형의 차이를 밝히기 위해 실시되었다. 연구 설계로 지지적 간호행위에 대한 인식유형은 Q-방법론을 이용하여 규명한 후 왓슨의 돌봄행동 모델의 틀로 분류하였으며 인식유형의 차이는 COM을 이용하여 분석하였다. 본 연구에 대한 결과는 다음과 같다. 1. 지지적 간호행위에 대한 암환자의 인식유형은 공감표현하기, 긍정적응대하기, 존중해주기이고 암환자가 추정하는 간호사의 인식유형은 희망북돋우기, 전문성발휘하기, 적절한정보주기, 개별요구에대처하기로 나타났다. 2. 지지적 간호행위에 대한 간호사의 인식유형은 친화적소통하기, 숙련된간호하기, 맞춤형간호하기이고 간호사가 추정하는 암환자의 인식유형은 환자입장에서생각하기, 진심으로경청하기, 신뢰를주기, 마음으로위로하기로 나타났다. 3. 지지적 간호행위에 대한 대 인간관계는 객관적 일치도에서 암환자의 존중해주기와 간호사의 숙련된간호하기, 암환자의 존중해주기와 간호사의 친화적소통하기가 부분적으로 일치하였고 암환자의 공감표현하기와 긍정적응대하기는 일치하는 유형이 없었다. 4. 암환자의 인식과 암환자가 추정하는 간호사의 인식의 주관적 일치도에서 공감표현하기와 희망북돋우기, 존중해주기와 전문성발휘하기가 부분적으로 일치하였다. 5. 간호사의 인식과 간호사가 추정하는 암환자의 인식의 주관적 일치도에서 친화적소통하기와 진심으로경청하기, 친화적소통하기와 환자입장에서생각하기, 숙련된간호하기와 환자입장에서생각하기, 숙련된간호하기와 진심으로경청하기, 맞춤형간호하기와 신뢰를주기가 부분적으로 일치하였다. 그러나 간호사가 추정하는 암환자의 인식유형 중 마음으로위로하기는 일치하는 유형이 없었다. 6. 암환자의 인식과 간호사가 추정하는 암환자의 인식의 정확도에서는 공감표현하기와 마음으로위로하기, 존중해주기와 환자입장에서생각하기가 부분적으로 일치하였다. 7. 간호사의 인식과 암환자가 추정하는 간호사의 인식의 정확도에서 친화적소통하기와 적절한정보주기, 숙련된간호하기와 맞춤형간호하기, 전문성발휘하기와 개별요구에대처하기, 맞춤형간호하기와 개별요구에대처하기가 부분적으로 일치하였다. 그러나 암환자가 추정하는 간호사의 인식유형 중 희망북돋우기는 일치하는 유형이 없었다. 결론적으로 지지적 간호행위에 대한 인식에 있어 암환자들은 간호사의 언어적, 비언어적 행위, 환자존중, 희망 등 정서적, 표현적 간호행위를 지지적 간호행위로 인식하고 있었다. 그러나 간호사들은 지지적 간호행위에서 경청, 정보, 숙련된 실무, 개별간호에 비중을 두고 있어 두 집단 간 인식의 차이를 확인할 수 있었다. 따라서 지지적 간호행위에 대한 암환자와 간호사의 인식의 차이를 극복하기 위해서는 간호실무에서 지지적 간호에 대한 환자요구에 대해 정확한 사정이 이루어져야 하고 그에 적합한 지지적 간호가 제공되어야 할 것이다. 또한, 간호사는 암환자를 위한 지지적 간호행위를 실천하기 위해 환자의 상태에 대해 진심으로 공감하고 긍정적으로 응대하며 환자 중심 간호를 수행해야 할 것이다.
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http://kumel.medlib.dsmc.or.kr/handle/2015.oak/40284
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3. Thesis (학위논문) > 3. ETC. (기타) > ETC. (기타)
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