장기요양시설에서 치매 노인을 돌보는 간호사의 도덕적 고뇌에 대한 경험
Nurses' Moral Distress on Caring for Older Adults with Dementia Residing in Long-Term Care Centers
1
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Purpose: This study aimed to understand nurses' experiences of moral distress when caring for elderly dementia patients who reside in long-term care centers. Methods: Colaizzi’s phenomenological approach was used for this study. The participants included eight nurses. Semi-structured in-depth interviews were used to collect data from February to August 2019. Results: Three categories emerged from the analysis. The nurses reported experiences of moral distress when caring for older adults with dementia. Theses experiences included “worrying about sincere care”, “a sense of guilt about task-oriented care”, “a feeling of helplessness because they cannot advocate care”. Seven theme clusters and 17 themes emerged in this study. The participants stated feeling conflicted about the meaning of care when they know secondary problemes will occur, but inevitably choose the next-best care option. The nurses could not provide proper care to their patients due to their overburdened workloads. The participants experienced a sense of guilt for caring only about the task at hand, without empathy. They felt helpless because that could not represent human rights and felt the gap between principle and reality as a nurse. Conclusion: These results suggest nurses’ moral distress must be considered to improve elderly dementia care. It is ethically and morally necessary for education programs to focus on caring for elderly dementia patients, and these findings can guide the program’s content and direction.
Abstract
Purpose: This study aimed to understand nurses' experiences of moral distress when caring for elderly dementia patients who reside in long-term care centers. Methods: Colaizzi’s phenomenological approach was used for this study. The participants included eight nurses. Semi-structured in-depth interviews were used to collect data from February to August 2019. Results: Three categories emerged from the analysis. The nurses reported experiences of moral distress when caring for older adults with dementia. Theses experiences included “worrying about sincere care”, “a sense of guilt about task-oriented care”, “a feeling of helplessness because they cannot advocate care”. Seven theme clusters and 17 themes emerged in this study. The participants stated feeling conflicted about the meaning of care when they know secondary problemes will occur, but inevitably choose the next-best care option. The nurses could not provide proper care to their patients due to their overburdened workloads. The participants experienced a sense of guilt for caring only about the task at hand, without empathy. They felt helpless because that could not represent human rights and felt the gap between principle and reality as a nurse. Conclusion: These results suggest nurses’ moral distress must be considered to improve elderly dementia care. It is ethically and morally necessary for education programs to focus on caring for elderly dementia patients, and these findings can guide the program’s content and direction.
참고문헌 (22)
- "The status of dementia" (2018)[URL]
- "2019 Major statistics on long-term care insurance for the elderly in the first half of the year" (2019)[URL]
- Joo BH, "The current status and challenges of housing support policy for the elderly with dementia", Health and Welfare Policy Forum, 276, pp.59~73 (2019)
- 김지아, "요양병원 간호사의 도덕적 고뇌와 도덕적 민감성", 한국산학기술학회논문지, 19(6), pp.240~251 (2018), 한국산학기술학회[DOI]
- Spenceley S, "Sources of moral distress for nursing staff providing care to residents with dementia", Dementia, 16(7), pp.815~834 (2017)[DOI]
- Awosoga O, "Development and validation of the moral distress in dementia care survey instrument", Journal of Advanced Nursing, 74(11), pp.2685~2700 (2018)[DOI]
- Pijl-Zieber EM, "Caring in the wake of the rising tide : moral distress in residential nursing care of people living with dementia", Dementia, 17(3), pp.315~336 (2018)[DOI]
- 김현숙, "요양병원 및 요양시설 간호사의 도덕적 고뇌 영향요인", 한국컴퓨터정보학회논문지, 24(5), pp.121~130 (2019), 한국컴퓨터정보학회[DOI]
- 유명숙, "간호사의 도덕적 고뇌(moral distress) 측정 도구개발", 박사, 간호학, pp.2003
- 김해리, "병원 간호사의 도덕적 민감성과 도덕적 고뇌", 한국의료윤리학회지, 13(4), pp.321~336 (2010), 한국의료윤리학회[DOI]
- 채영란, "병원간호사의 도덕적 고뇌, 신체증상 및 소진의 관계", 한국간호교육학회지, 23(4), pp.430~440 (2017), 한국간호교육학회[DOI]
- 유명숙, "일 지역 간호사의 도덕적 고뇌 정도", 간호행정학회지, 12(1), pp.131~139 (2006), 간호행정학회
- "2019 Long-term care survey" (2020)[URL]
- Colaizzi PE, "Existential-phenomenological existential alternative for psychology", pp.48~71 (1978), Oxford University Press
- Guba EG, "Effective evaluation: improving the usefulness of evaluation results through responsive and naturalistic approaches", pp.85~127 (1981), Jossey-Bass
- Oh Y, "Moral distress experienced by nurses : a quantitative literature review", Nursing Ethics, 22(1), pp.15~31 (2015)[DOI]
- Corley MC, "Development and evaluation of a moral distress scale", Journal of Advanced Nursing, 33(2), pp.250~256 (2001)[DOI]
- 조행난, "간호사의 도덕적 고뇌 정도에 대한 이직의도의 차이", 한국콘텐츠학회 논문지, 15(5), pp.403~413 (2015), 한국콘텐츠학회[DOI]
- Lee NK, "Coping experience of moral distress in emergency nurses", Master, pp.2016
- 이동현, "치매 환자에서의 부적절한 성행동", 노인정신의학, 14(1), pp.9~14 (2010), 대한노인정신의학회
- 최희경, "치매인을 위한 인권중심 사회복지실천의 방향과 방안에 대한 연구", 노인복지연구, 72(1), pp.69~91 (2017), 한국노인복지학회[DOI]
- 전찬희, "요양보호사의 노동인권에 관한 고찰", 한국콘텐츠학회 논문지, 13(5), pp.234~242 (2013), 한국콘텐츠학회[DOI]