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간호사가 경험한 도덕적 고뇌에 관한 통합적 문헌고찰: 국내문헌을 중심으로

Moral Distress Experienced by Nurses in South Korea: An Integrated Review

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주제분류의학일반

초록

현대의 급변하는 보건의료현장에서 간호사는 자신의 도덕적 신념이나 윤리원칙과는 상충되는 윤리 적 의사결정에 어쩔 수 없이 따르기도 하는데 이때 도덕적 고뇌를 경험한다. 본 연구의 목적은 통합적 문헌고찰을 통해 국내문헌을 중심으로 간호사의 도덕적 고뇌에 대해 알아보고자 한다. 1984년 1월부터 2015년 12월 기간에 출판된 문헌들 중 최종적으로 선택된 7편의 문헌결과를 종합 및 분석하였다. 문헌 고찰 결과 국내의 많은 간호사들이 윤리적 딜레마 상황에서 도덕적 고뇌를 경험하고 있으며, 이때 다양 한 부정적인 심리반응을 나타내며, 어떤 간호사의 경우 이직이나 사직으로 고려한 경우가 있는 것으로 확인되었다. 향후 간호사의 도덕적 고뇌의 완화를 위한 조직의 체계적인 관리와 관련 프로그램 개발 및 효과측정 연구가 필요하다.

Abstract

Nurses are frequently faced with ethical dilemmas in their nursing practice. Nurse can experience moral distress when they know the morally correct response to a situation but cannot act accordingly because of institutional or hierarchical constraints. The aim of this integrated review was to synthesize the available quantitative and qualitative evidence in the literature on moral distress experienced by nurses. We appraised seven articles published between January 1984 and December 2015. This review revealed that many nurses in South Korea experience moral distress associated with difficult care situations and feel negative psychological symptoms, which can have an impact on their job performance. Further research is required to examine workplace strategies to support nurses in these situations and to develop coping strategies for dealing with moral distress.

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