신생아집중치료실 캥거루케어에 대한 간호사와 의사의 인식
Perception of Nurses and Physicians in Neonatal Intensive Care Units on Kangaroo Care
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본 연구는 국내 대학병원을 중심으로 캥거루케어 여부를 조사하고, 캥거루케어의 인식과 장애요인을 파악하여 캥거루케어의 국내 임상적용을 위한 기초자료를 제공하고자 시도되었다. 간호사와 의사 모두 캥거루케어에 대해서는 대체로 긍정적인 편이어서 캥거루케어가 애착을 촉진시키고 신체적 건강에 효과가 있으며 부모의 자신감을 증진시킨다는 항목에 대체적으로 동의하는 것으로 나타난 반면, 삽관하고 있거나 1,000 g 이하의 미숙아, 출생 후 몇 시간 이내의 신생아에게 시행하는 캥거루케어에 대해서는 외국에서 실제 캥거루케어를 시행하고 있는 병원의 의료진보다 부정적인 평가를 하였다. 캥거루케어에 대한 주요 장애요인으로는 캥거루케어로 인해 삽관이나 혈관이 빠질 수 있다는 두려움과 안전과 관련한 두려움인 것으로 나타났으며, 결혼을 하였거나 임상경력이 많은 간호사는더 긍정적인 태도를 보였다. 특히 캥거루케어를 현재 시행하고 있는 경우 그렇지 않은 경우에 비해 캥거루케어에 대한 장애를 낮게 인식하고 있다는 것은 캥거루케어 시행 시의 현실적인 문제보다 시행도 해보기 전 우려가 많아 장애가 되고 있음을 나타내는 결과이다. 따라서 캥거루케어의 확산을 위해서는 의료진들부터 이에 대한 적절한 인식이 필요하며 향후 적용을 위해서는 적용대상 기준과 안전에 대한 지침을 마련하고 적절한 교육을 통해 준비시킬 필요가 있겠다.
Abstract
Purpose: To identify the perception and practices of kangaroo care in nurses and doctors working in neonatal intensive care units (NICU) in Korea. Methods: One hundred forty-nine nurses and nineteen doctors working in the NICU from six university hospitals completed a survey questionnaire. Results: Most agreed that Kangaroo care promoted attachment and parental confidence as well as physical health of the infant. However, nurses and doctors showed a negative perception in providing kangaroo care for premature infants under 1,000 grams or within several hours after birth. Major barriers for kangaroo care were worrying about extubation and safety problems of premature infants. Married or senior nurses showed a more positive perception than others. Also nurses who worked in hospitals where kangaroo care was provided had a lower barrier perception than other nurses. Conclusion: Nurses and doctors working in NICU worried about adverse effects of kangaroo care even though they perceived positive effects. Standard education programs and manuals should be developed before dissemination of kangaroo care in Korea.
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