간호대학생의 DNR 교육 경험과 심폐소생술금지에 대한 윤리적 태도
Nursing Students' Ethical Attitudes toward DNR: The Impact of Educational Experience
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초록
본 연구는 전북소재 일개 간호대학생 209명을 대상으로 DNR에 대한 윤리적 태도를 파악하고자2022년 9월에서 11월까지 자료수집하고, 수집된 자료는 SPSS WIN 25.0 프로그램을 이용하여 기술통계와 χ2-test로 분석하였다. 간호대학생들의 DNR에 대한 윤리적 태도를 살펴본 결과, 환자의 의사존중, 정확한 정보제공, DNR 지침준수에 대체로 동의하였으며, DNR 결정 후에라도 보호자의요청에 따른 치료 제공 및 DNR 환자에 대한 무균 원칙 유지 등에 동의하는 경향이 있었다. 가족이 원할 경우 인공호흡기 작동 중단, 살 가망이 없는 환자라도 모든 방법을 동원한 생명 연장, 주치의의 DNR 결정 등에는 중립적 태도를 나타냈다. DNR이 선언된 후 의료진의 관심 감소는 반대의견이 많았다. 19문항 중 ‘말기 환자에게 모든 치료를 사용하는 것’(p=.028)과 ‘동료가 DNR 환자를 무균절차없이 치료하는 것을 목격하면 즉시 조언한다’ 문항(p=.014)에서 DNR 관련 교육경험에따른 유의한 차이가 있었다. DNR 상황과 절차, 관련 기준에 대한 더 정확한 근거에 대한 교육이제공되어야 하며, 높은 수준의 상황적 윤리적 역량을 유지하기 위한 체계적인 교육이 필요하다.
Abstract
This study investigated the ethical attitudes towards Do Not Resuscitate (DNR) among nursing college students. Data were collected from September to November 2022, involving 209 students in Jeonbuk Province. Analysis was done using SPSS WIN 25.0 with descriptive statistics and the χ2-test. Students generally agreed with respecting patient wishes, providing accurate information, and adhering to DNR guidelines. They supported treatment upon guardian request and maintaining aseptic principles for DNR patients. They showed neutral attitudes towards discontinuing mechanical ventilation upon family request, using all means to prolong life for patients with no chance of survival, the primary physician's DNR decision, etc. There was often opposition to the decline in medical team interest after DNR declaration. Significant differences based on DNR education experience were found regarding the use of all treatments for terminally ill patients (p=.028) and the need to advise if a co-worker treats a DNR patient without aseptic procedures (p=.014). Education on DNR situations and procedures is essential for accurate knowledge and high ethical competence.
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