요양병원 간호사의 죽음인식과 임종간호 태도

Abstract

This is a descriptive researchstudy, which aims to see death perceptions and terminal care attitude of long-term care (LTC) hospital nurses. The research looked at 165 nurses who has had worked more than six months and have had experience in terminal care, working in seven different long-term care (LTC) hospitals located in Gyeongbuk province. The research data was collected from March 16, 2015 to March 24, 2015.As the research tool, Inumiya Yoshiyuki’s view of life and death scale, excluding the afterlife view, was used to measure the death perceptions, and Frommelt’s FATCOD (Frommelt Attitudes Toward Care of Dying Scale) was used for attitudes toward terminal care. Data analysis was carried out by using the program SPSS 21.0. The findings of this study were as follows; 1. Regarding the death perceptions of the subjects, an understanding of the positive meaning was 4.62 out of 7, an understanding of the negative meaning was 4.73, a death anxiety was 4.20, a death concern was 3.70, and a will for life respect was 4.62 on average. And a terminal care attitude was 3.53 out of 5. 2. Regarding the variables which showed statistically significant differences in the death perceptions that varied according to general characteristics of the subjects, there were differences in understandings on the positive meaning of death (t = -2.04, p = .043), and on the negative meaning of death (t = 2.37, p = .019) in terms of the subjects’ academic abilities. In case of death concern, there was in terms of positions (F = 4.43, p = .005), and in case of a will for life respect, there was in terms of an importance for religion (F = 3.18, p = .026) and their terminal care type (F = 3.73, p = .027). 3. The differences in terminal care attitude according to general characteristics of the subjects was time of education for dying(F = 3.33, p = .007) and experiences with the death of a family member or acquaintance in the last year (F = 2.39, p = .040). 4. It was also found that a terminal care attitude has positive correlations with a positive meaning of death (r = .26, p = .001), death concern (r = .22, p = .004), and will for life respect (r = .24, p = .002), respectively, while it has had a negative correlation with death anxiety (r = -.29, p < .001). In conclusion, it was found that a terminal care attitude becomes became high, as the subjects has had a higher awareness on a positive meaning of death, higher death concern, higher will for life respect, or a lower death anxiety. Therefore, research and development activities for terminal care program will be needed more and more to reinforce an awareness on a positive meaning of death, death concern, and will for life respect, and in the meantime, to lower a death anxiety, in order to improve a the terminal care attitude of LTC hospital nurses.

본 연구는 요양병원 간호사의 죽음인식과 임종간호 태도에 관해 알아보기 위한 서술적 조사연구이다. 본 연구의 대상자는 경북지역에 소재한 7개 요양병원에서 6개월 이상 근무하고 임종간호 경험이 있는 간호사 165명이다. 자료 수집은 2015년 3월 16일부터 3월 24일까지 하였다. 연구도구로 죽음인식은 이누미야 요시유키의 내세관을 제외한 사생관 척도 (View of Life and Death Scale)와 임종간호 태도는 Frommelt의 FATCOD (Frommelt Attitudes Toward Care of Dying Scale)를 사용하였다. 자료 분석은 SPSS 21.0 프로그램을 이용하여 분석하였다. 연구결과는 다음과 같다. 1. 대상자의 죽음인식 중 긍정적 의미에 대한 이해는 7점 만점에 평균 4.62점, 부정적 의미에 대한 이해는 평균 4.73점, 죽음불안은 평균 4.20점, 죽음관여도는 평균 3.70점, 생명존중의지는 평균 4.62점이었으며 임종간호 태도는 5점 만점에 3.53점이었다. 2. 대상자의 일반적 특성에 따른 죽음인식 차이에서 통계적으로 유의 미한 차이가 나타난 변수들은 최종학력에서 죽음의 긍정적 의미에 대한 이해 (t=-2.04, p=.043), 죽음의 부정적 의미에 대한 이해 (t= 2.37, p=.019) 의 차이가 있었으며, 죽음관여도에서는 직위 (F=4.43, p= .005), 생명존중의지에서는 종교에 대한 중요도 (F=3.18, p=.026), 자신의 임종간호 유형 (F=3.73, p=.027)으로 나타났다. 3. 대상자의 일반적 특성에 따른 임종간호 태도 차이는 임종관련 교육시간 (F=3.33, p=.007), 최근 1년 이내 죽음경험 대상자 (F=2.39, p=.040) 이었다. 4. 임종간호 태도와 죽음의 긍정적 의미 (r=.26, p=.001), 죽음관여도 (r=.22, p=.004), 생명존중의지 (r=.24, p=.002)는 각 양의 상관관계가 있었고. 죽음불안 (r=-.29, p<.001)은 음의 상관관계가 있었다. 결론적으로 대상자의 죽음의 긍정적 의미에 대한 인식이 높을수록, 죽음관여도가 높을수록, 생명존중의지가 높을수록, 죽음불안이 낮을수록 임종간호 태도가 높아지는 것으로 나타났다. 따라서 요양병원 간호사의 긍정적인 임종간호 태도를 위해서는 죽음의 긍정적 의미에 대한 인식과 죽음관여도, 생명존중 의지를 강화시키고 죽음불안을 낮출 수 있는 임종간호 프로그램 개발에 관한 연구가 필요할 것이다.