종합병원 간호사의 섬망 간호 수행 영향 요인

Abstract

This study was conducted to identify factors affecting nursing performance for patients with delirium among general hospital clinical nurses. In order to identify these factors, a cross-sectional survey was adopted. The survey was carried out from July 20 to July 30, 2015, with a sample consisting of 167 nurses registered in three general hospitals. The measurements that were used to investigate the factors affecting nursing performance for patients with delirium are nursing performance level for patients with delirium, knowledge about delirium, self-confidence in caring for patients with delirium, stress related to delirium and nursing work environment. The data were analyzed with SPSS 21.0 using frequency analysis, t-test, ANOVA, Scheffe test, Pearson's correlation coefficients and linear regression analysis. The mean score for nursing performance level for patients with delirium was 2.90±0.44, knowledge about delirium was 27.82±4.32, self-confidence in caring for patients with delirium was 58.89±17.75, stress related to delirium was 62.97±12.97 and nursing work environment was 3.28±0.43. According to the general characteristics and work characteristics of subject, the nursing performance level for patients with delirium showed significant differences in age(F=6.23, p<.001), marital status(t=-0.25, p=.012), monthly income(F=4.06, p=.002), education level(F=3.29, p=.040), clinical experience(F=5.43, p=.001) and experience in nursing education about delirium(t=3.27, p=.001). Nursing performance level for patients with delirium had significant positive correlations with knowledge about delirium(r=.25, p=.001), self-confidence in caring for patients with delirium(r=.45, p<.001) and nursing work environment(r=.29, p<.001). In this study, factors affecting nursing performance for patients with delirium were self-confidence in caring for patients with delirium(β=.33, p<.001), nursing work environment(β=.26, p<.001), experience in nursing education about delirium(β=.18, p=.007) and clinical experience(β=.18, p=.007). The factors explained 32% of nursing performance for patients with delirium. This study's results can be used as basic data to develope educational programs related to delirium care through continuing education and to improve work environments in developing strategies to enhance nursing performance for patients with delirium.

본 연구는 종합병원 간호사의 섬망 간호 수행에 미치는 영향 요인을 파악하기 위하여 실시되었다. 본 연구는 횡단적 조사 연구이다. 본 연구의 자료수집 기간은 2015년 7월 20일부터 7월 30일까지이며, 연구 대상자는 3개의 종합병원에 근무하고 있는 간호사 167명을 대상으로 하였다. 연구도구는 섬망 간호 수행도, 섬망 관련 지식, 섬망 간호 자신감, 섬망 간호 스트레스, 간호 근무환경 도구를 사용하였으며, 자료분석은 SPSS 21.0을 이용하여 빈도분석, t-test, ANOVA, Scheffe test, Pearson correlation coefficients, 선형회귀분석을 사용하였다. 간호사의 섬망 간호 수행도는 평균 2.90±0.44점, 섬망 관련 지식은 평균 27.82±4.32점, 섬망 간호 자신감은 평균 58.89±17.75점, 섬망 간호 스트레스는 평균 62.97±12.97점, 간호 근무환경은 평균 3.28±0.43점으로 나타났다. 간호사의 일반적·직무적 특성에 따른 섬망 간호 수행도의 차이에서 연령(F=6.23, p<.001), 결혼상태(t=-0.25, p=.012), 월소득(F=4.06, p=.002), 최종학력(F=3.29, p=.040), 임상경력(F=5.43, p=.001), 섬망 간호 교육경험(t=3.27, p=.001)에서 유의한 차이가 나타났다. 섬망 간호 수행도와 섬망 관련 지식(r=.25, p=.001), 섬망 간호 자신감(r=.45, p<.001), 간호 근무환경(r=.29, p<.001)에서 통계적으로 유의한 정적인 상관관계가 있었다. 섬망 간호 수행에 미치는 영향 요인을 분석한 결과, 섬망 간호 자신감(β=.33, p<.001), 간호 근무환경(β=.26, p<.001), 섬망 간호 교육경험(β=.18, p=.007), 임상경력(β=.18, p=.007)이 영향 요인으로 나타났고 전체 설명력은 32%이다. 결론적으로, 본 연구를 토대로 섬망 간호 수행 증진을 위한 전략 개발 시 섬망 간호 자신감 증진을 위한 교육 프로그램, 지속적인 교육 및 근무환경 개선 노력이 고려되어야 할 것이다.