임상적 의사결정과 생명의료윤리에 대한 환자, 가족, 간호사와 의사의 인지도
Recognition of Patients, Families, Nurses, and Physicians about Clinical Decision-making and Biomedical Ethics
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Purpose: To identify the recognition of patients, families, nurses, and physicians about clinical decision-making and biomedical ethics. Methods: Data were collected from October 23 to 30, 2012 using the structured questionnaires. A total of 200 data were analyzed usingSPSS 20.0 version. Results: Response about ’who should receive the first notice of a cancer diagnosis?’ was significant differencestatistically. Cancer patients had preferences to be notified their diagnosis first. Patients responded the person who made decision oftreatment options would be physician first and then themselves. Families, nurses, and physicians answered that decision-maker wouldbe both of patient and family. All four groups answered that the person who made decision about care-giver after discharge was patientand their family. Nurses and physicians who didn’t aware of the advanced directive were over 30.0%, and patients and family whodidn't aware of that were over 60.0%. Lastly, the rate of positive answer about making attempt of advanced directive after legalizationwas over 80.0%. Conclusion: Patient’s attitude about making decisions is different from family’s attitude. Nurses and physicians haveto put emphasis on the patient’s autonomy & self-determination and family members’ needs.
Abstract
Purpose: To identify the recognition of patients, families, nurses, and physicians about clinical decision-making and biomedical ethics. Methods: Data were collected from October 23 to 30, 2012 using the structured questionnaires. A total of 200 data were analyzed usingSPSS 20.0 version. Results: Response about ’who should receive the first notice of a cancer diagnosis?’ was significant differencestatistically. Cancer patients had preferences to be notified their diagnosis first. Patients responded the person who made decision oftreatment options would be physician first and then themselves. Families, nurses, and physicians answered that decision-maker wouldbe both of patient and family. All four groups answered that the person who made decision about care-giver after discharge was patientand their family. Nurses and physicians who didn’t aware of the advanced directive were over 30.0%, and patients and family whodidn't aware of that were over 60.0%. Lastly, the rate of positive answer about making attempt of advanced directive after legalizationwas over 80.0%. Conclusion: Patient’s attitude about making decisions is different from family’s attitude. Nurses and physicians haveto put emphasis on the patient’s autonomy & self-determination and family members’ needs.
참고문헌 (30)
- 서원식, "의사와 환자 간 공유된 진료의사결정이 환자만족도에 미치는 영향", 예방의학회지, 43(1), pp.26~34 (2010), 대한예방의학회
- 이효진, "의학적 의사결정의 실천 모델: 환자, 의사, 사회, 세 가지 주된 힘의 상호작용을 중심으로", 한국의료윤리학회지, 16(1), pp.59~76 (2013), 한국의료윤리학회
- Johnston B, "Nurses and patients perceptoins of expert palliative nursing care", J Adv Nurs, 54(6), pp.700~709 (2006)
- 권복규, "우리나라 일부 병원에서 환자, 보호자, 의료진의 연명치료 중지 관련 의사결정에 관한 태도", 한국의료윤리학회지, 13(1), pp.1~16 (2010), 한국의료윤리학회
- 안선화, "환자의 알권리와 자기결정", 한국의료윤리학회지, 12(2), pp.153~164 (2009), 한국의료윤리학회
- 이상목, "암환자의 의학적 의사결정과정", 한국의료윤리학회지, 12(1), pp.1~14 (2009), 한국의료윤리학회
- 김진경, "의학적 의사결정 모델로써 공동의사결정의 이해", 한국의료윤리학회지, 11(2), pp.105~118 (2008), 한국의료윤리학회
- 조계화, "말기 환자에 대한 한국형 의료적 의사결정 체계 구축을 위한 델파이연구", 한국의료윤리학회지, 14(2), pp.131~144 (2011), 한국의료윤리학회
- Yun YH, "The attitudes of cancer patients and their families toward the disclosure of terminal illness", J Clin Oncol, 22(2), pp.307~314 (2004)
- Baile WF, "Oncologists’ attitudes toward and practices in giving bad news: an exploratory study", J Clin Oncol, 20(8), pp.2189~2196 (2002)
- 조계화, "말기의 의료적 의사결정에 관한 임상간호사의 갈등경험", 성인간호학회지, 22(5), pp.488~498 (2010), 성인간호학회
- 이혜경, "간호사가 경험하는 윤리적 딜레마와 소진 및 대처와의 관계", 한국의료윤리학회지, 15(3), pp.339~354 (2012), 한국의료윤리학회
- 이상목, "의학적 의사결정에서 환자의 결정과 가족의 결정", 한국의료윤리학회지, 12(4), pp.323~334 (2009), 한국의료윤리학회
- 조계화, "의료인이 인식하는 말기의 적절한 의료적 의사결정 저해요인 분석", 한국의료윤리학회지, 14(4), pp.427~442 (2011), 한국의료윤리학회
- 조계화, "킹의 이론에 근거한 공유된 한국형 의료적 의사결정 모델", 한국의료윤리학회지, 15(2), pp.184~205 (2012), 한국의료윤리학회
- Han SS, "The nature of ethical dilemmas and decision making in hospital nursing practice", 박사, pp.1992
- Reem JS, "Biomedical ethics and ethical theory", Korean J Med Ethics, 1(1), pp.1~20 (1998)
- 신영태, "사전의사결정(Advance Directives, 死前意思決定)에 대한 사법연수원생들과 전공의와 수련의들의 인식도 조사", 한국의료윤리학회지, 11(1), pp.23~36 (2008), 한국의료윤리학회
- 전인희, "암 진단 고지에 대한 암 환자의 인식", Asian Oncology Nursing, 13(2), pp.59~66 (2013), 대한종양간호학회
- Tuckett AG, "Truth-telling in clinical practice and the arguments for and against: a review of the literature", Nurs Ethics, 11(5), pp.500~513 (2004)
- Loh A, "The effects of a shared decision-making intervention in primary care of depression: a cluster-randomized controlled trial", Patient Educ Couns, 67(3), pp.324~332 (2007)
- Lepping P, "Overvaluing autonomous decision-making", Br J Psychiatry, 204, pp.1~2 (2014)
- Briggs L, "The nurse’s role in end-of-life decision-making for patients and families", Geriatr Nurs, 23(6), pp.302~310 (2002)
- Royak-Schaler R, "Family perspectives on communication with healthcare providers during end-of-life cancer care", Oncol Nurs Forum, 33(4), pp.753~760 (2006)
- Surbone A, "Telling the truth to patients with cancer: what is the truth", Lancet Oncol, 7(11), pp.944~950 (2006)
- 함미영․최경숙, "퇴원 후 암환자의 간호요구에 관한 연구", Asian Oncology Nursing, 1(2), pp.147~156 (2001), 대한종양간호학회
- 최은숙, "말기 암환자 가족의 돌봄 경험", Journal of Korean Academy of Nursing, 42(2), pp.280~290 (2012), 한국간호과학회[DOI]
- 고윤석, "연명치료 중지에 관한 지침의 특징과 쟁점", 대한의사협회지, 54(7), pp.747~757 (2011), 대한의사협회
- 홍선우, "지역사회 거주 노인의 임종기 치료, 연명치료, 사전의료의향서에 대한 지식", 한국간호교육학회지, 19(3), pp.330~340 (2013), 한국간호교육학회
- 손덕승, "호스피스병동 말기 암 환자 및 내과의사의 사전의료지시(서)에 대한 인식", 한국호스피스완화의료학회지, 12(1), pp.20~26 (2009), 한국호스피스완화의료학회