중환자실 간호사의 업무부담 관련 요인: 체계적 문헌고찰 및 메타분석
Factors Related to Workload of Intensive Care Unit Nurses: Systematic Review and Meta-Analysis
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목적: 본 연구는 체계적 문헌고찰 및 메타분석을 통해 중환자실 간호사의 업무부담과 관련된 요인을 파악하고, 간호 인력 배치 기준의 발전 방향을 모색하기 위한 기본자료를 제공하고자 하였다. 방법: 본 연구에는 2000년부터 발표된 한국어 또는 영어로 된 중환자실에서 근무하는 간호사와 관련된 업무부담에 대한 정량적 연구가 포함되었다. 검색어로는 ‘중환자실', ‘간호 업무부담'을 병합하는 용어가 사용되었으며, RISS, DBpia, MEDLINE (PubMed), CINAHL, PsycINFO, Web of Science 등의 데이터베이스가 활용되었다. 분석문헌의 질 평가는 Joanna Briggs Institute의 Critical Appraisal Checklist for Analytical Cross Sectional Studies를 사용하여 시행하였다. 또한 JAMOVI 프로그램을 이용하여 상관관계 또는 회귀 분석 자료를 가진 7개 연구에 대한 효과크기의 분석을 시행하였다. 결과: 중환자실 간호사의 업무부담에 대한 16개 연구에서 총 20개의 환자 및 간호사 관련 요인이 파악되었다. 환자와 관련된 요인으로는 질병의 중증도, 재원 기간, 나이 등이 있었다. 메타분석은 환자의 나이, SAPS 3으로 측정된 중증도, 재원 기간의 세 가지 환자 관련 요인에 대해 시행하였다. SAPS 3으로 측정된 중증도만이 간호사의 업무부담과 유의하게 관련된 것으로 나타났다(Zr=0.16, p<0.001, 95.0% CI=0.09-0.23). 결론: 연구별로 중환자실 및 환자의 특성이 다양하게 나타났으며, 업무부담 및 중증도를 측정하는 척도도 다양하였다. 국내 중환자실의 업무 환경을 반영하고 중환자실 간호사의 업무부담을 평가하는 지속적인 연구가 필요하다.
Abstract
Purpose: This study aimed to identify factors related to the workload of intensive care unit nurses through asystematic literature review and meta-analysis to provide basic data to explore the direction of developmentof nursing staffing standards. Methods: This study involved quantitative studies about nurses working inintensive care units related to nursing workload published in English or Korean since 2000. Search termsincluded 'intensive care unit', 'nursing workload', and their variations. Databases such as RISS, DBpia,MEDLINE(PubMed), CINAHL, PsycINFO, and Web of Science were utilized. Quality assessment wasconducted using the Joanna Briggs Institute's Critical Appraisal Checklist for Analytical Cross-Sectional Studies. JAMOVI software facilitated the analysis of effect sizes, employing a meta-analysis approach for 7 studies withcorrelational or regression data. Results: From 16 studies on the workload of intensive care unit nurses, a totalof 20 patient and nurse-related factors were identified. Patient-related factors included severity of illness,length of stay, and age. Meta-analysis was conducted for three patient-related factors: age, severity of illnessmeasured by SAPS 3, and length of stay. Only severity of illness measured by SAPS 3 was significantlyassociated with nurse workload (Zr=0.16, p<.001, 95% CI=0.09-0.24). Conclusion: In previous studies, thecharacteristics of intensive care units and patients varied across studies, and a variety of scales for measuringworkload and severity of illness were also used. Sustained research reflecting domestic intensive care unit workenvironments and assessing the workload of intensive care unit nurses should be imperative.
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