Factors Influencing Performance of End-of-life Care by ICU Nurses

Abstract

Purpose: This study was a descriptive research to assess the level of and the relationship of related factors in the performance of end-of-life care by intensive care unit (ICU) nurses. Methods: Participants were 238 ICU nurses from university and general hospitals. Data were collected, using structured questionnaires, and collected data were analyzed using t-test, ANOVA, ScheffétestScheffétest, Pearson correlation coefficients, and multiple regression analysis with SPSS/WIN 22.0. Results: There were significantly positive effects between performance of end-of-life care and end-of-life care attitudes. Performance end-of-life care was negatively associated with end-of-life care stress and obstacles. Factors that significantly influenced ICU nurses' performance of end-of-life were end-of-life care stress, medical team in obstacles related to end-of-life care, and end-of-life care attitudes, which explained about 53% of the variance in the performance of end-of-life care. Conclusion: Findings indicate that hospital organizations should carry out stress management and counseling programs in order to lower ICU nurses' end-of-life care stress, and to enhance end-of-life care attitudes. In addition, concern needs to be given to the medical team which was one of the obstacles to end-of-life care. It is also necessary to decrease the heavy workload and increase the communication with medical workers. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 서 론 1. 연구의 필요성 의료기술의 발달로 생명연장이 가능해지면서 생의 마지막 까지 병원에서 보내는 사람들이 늘어나고 있으며, 2014년 전체 사망자 중 의료기관 사망자는 73.1%로 나타나 10년 전보다 30%가 크게 증가하였다[1]. 의료기관 사망률이 증가하면서 임 종간호 제공 횟수가 늘어나고 있으며, 2016년 현재 국내에서는 호스피스간호를 제공할 수 있는 전문기관으로 전국 70곳, 1161 병상을 지정하여 운영하고 있다. 하지만 우리나라 인구 5천만 명을 기준으로 약 2,500개가 필요하나 정부가 지원하는 병상은 필요병상 수의 약 40%에 불과한 실정이다[2]. 2014년 전체 사망자는 267,692명으로 광주광역시 6,935명, 전라남도 16,053명으로 전체 10%정도이나, 2016년 광주 ․ 전남 호스피스 병상 수는 137개로 전체 사망자에 비하면 모자란 실 정이다[3]. 호스피스 병동의 부족으로 인하여 대다수의 말기 환자 및 만성질환자들의 임종간호가 급성기 치료중심의 중환