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방문간호사의 생애말기 간호에 대한 경험: 질적 내용분석
Experience of Visiting Nurse's End-of-life Care: A Qualitative Contents Analysis
방미성 (창원대학교 대학원 간호학과), 이인숙 (창원대학교 간호학과), 양주현 (창원문성대학교 간호학과), 김소희 (창원대학교 대학원 간호학과)
언어 :
권호 : v.29, no.2, 143-152,
발행일자 : 2022년 8월
PDF 원문보기초록
Purpose: This study aims to describe and explore the experiences of visiting nurses so as to providing high-quality end-of-life care at home. Methods: Data was collected and recorded through in-depth interviews with 11 visiting nurses and transcribed verbatim. The data were analyzed with qualitative contents analysis. Data were collected from April 8 to July 30, 2021. Results: The results revealed the following four themes and ten sub-themes: The main themes were 'Dignified end-of-life caring practice at home', 'Providing integrated support of end-of-life family caregivers', 'Confronting the limits of visiting nursing at the end of life' and 'Reflection on life and feeling rewarded'. Visiting nurses have performed dignified end-of-life care at home and integrated support for family caregivers. Although the visiting nurse sometimes faced the limits of visiting nursing during end-of-life care, it was surveyed that they rewarded on their lives and felt rewarding through the end-of-life nursing experience. Conclusion: Practical and systematic training is needed to positively change the end-of-life care of visiting nurses. We propose programs, such as expert counseling, to improve coping skills in end-of-life care practice at home. Additionally, we propose various institutional supports which can support the limitations of end-of-life care provision.
참고문헌 (30)
End of life care [Internet]. National Health Service, england [cited 2021 Oct 25]. Available from: https://www.nhs.uk/conditions/end-of-life-care/
2018 Community Integrated Health Promotion Project Guide, Visiting health care [Internet]. Seoul: Korea Health Promotion Foundation(KHPF), Ministry of Health and Welfare (MOHW) c2018[cited 2021 May 25]. Available from: https://www.khealth.or.kr/kps/publish/view?menuId=MENU00890&page_no=B2017003&pageNum=3&siteId=&srch_text=&srch_cate=&srch_type=&str_clft_cd_list=&str_clft_cd_type_list=&board_idx=10049
Lee SJ, Kwak CY. Effects of visiting nursing services in long-term care insurance on utilization of health care. Journal of Korean Academy of Community Health Nursing 2016;27(3):272-283. https://doi.org/10.12799/jkachn.2016.27.3.272
http://dx.doi.org/10.12799/jkachn.2016.27.3.272
Long-term Care Insurace [Internet]. Wonju: National Health Insurance Corporation [cited 2022 Apr 11]. Available from: https://www.longtermcare.or.kr/npbs/e/b/403/npeb403m01.web?menuId=npe0000000290&zoomSize=
Fukui F, Otsuki N, Ikezaki O, Fukahori S, Irie S. Provision and related factors of end-of-life care in elderly housing with care services in collaboration with visiting nurse agencies: a nationwide survey. BMC Palliative Care. 2021;20(1):1-9. https://doi.org/10.1186/s12904-021-00847-7
http://dx.doi.org/10.1186/s12904-021-00847-7
Costa V, Earle CC, Esplen MJ, Fowler R, Goldman R, Grossman D, et al. The determinants of home and nursing home death: a systematic review and meta-analysis. BMC palliative care. 2016;15(1):1-15. https://doi.org/10.1186/s12904-016-0077-8
http://dx.doi.org/10.1186/s12904-016-0077-8
Kim SE. The relationship between intensive care unit nurses' death perception and terminal care performance. [master's thesis]. Suwon: Ajou University; 2011. 53p.
Kim SH. Factors for end-of-life care performance among home visiting nurses. [dissertation]. Seoul: Chung-Ang University; 2020. 146p.
Detering KM, Hancock AD, Reade MC, Silvester W. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ. 2010;340. https://doi.org/10.1136/bmj.c1345
http://dx.doi.org/10.1136/bmj.c1345
Chung SY. A study on terminal care stress and terminal care performance of ICU nurse. [master's thesis]. Seoul: Hanyang University; 2013. 70 p.
Kim SJ. Death anxiety and terminal care attitudes of nurses in hospice palliative units. Nursing Science. 2015; 27(1):23-34.
Jung JS, Lee KS. Investigation of the relationships between death recognition, terminal care stress, and terminal care performance in terminal hospital nurses. Science of Emotion and Sensibility. 2020;23(1):79-88. https://doi.org/10.14695/kjsos.2020.23.1.79
http://dx.doi.org/10.14695/kjsos.2020.23.1.79
Seol, EM, Koh CK. Experiences of critical care nurses caring for dying patients. Journal of Korean Critical Care Nursing 2018;11(2):1-10.
Kang SY, Koh MH, Choi JS. The experience of hospice nurses on spiritual care: The process of untying a knot of mind. Asian Oncology Nursing. 2008;8(2):111-119.
Korean Statistical Information Service. Aging index [Internet]. Seoul: Statistics Korea; 2021 [cited 2022 February 15]. Available from: https://kosis.kr/visual/nsportalStats/detail.do?menuId=10&NUM=1016&cntUpd ate=Y
Oh JY, Lee DH, LIM JW, Shin YJ, Park DH, Yoo HR, et al. Study on improvement of hospice palliative care service in investigation system-focusing on strengthening linkage between types and promoting patient-centered integrated use. Research report. Wonju: Health Insurance Review & Assessment Service; 2020 February. Report No.: G000F8R-2020-27 https://repository.hira.or.kr/handle/2019.oak/2259
Choi SH, Jung JH, Jung SW. Concept and procedures of qualitative content analysis. Journal of Qualitative Inquiry. 2016;2(1):127-155.
Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005;15(9):1277-1288. https://doi.org/10.1177/1049732305276687
http://dx.doi.org/10.1177/1049732305276687
Elo S, Kyngas H. The qualitative content analysis process. Journal of advanced nursing. 2008;62(1):107-115. https://doi.org/10.1111/j.1365-2648.2007.04569.x
http://dx.doi.org/10.1111/j.1365-2648.2007.04569.x
Guba EG, Lincoln YS. Effective evaluation: Improving the usefulness of evaluation results through responsive and naturalistic approaches. Jossey-Bass, 1981. https://doi.org/10.1016/0738-0593(82)90012-8
http://dx.doi.org/10.1016/0738-0593(82)90012-8
Kim HS, Choi EK, Kim TH, Yun HY, Kim EJ, Hong JJ, et al. Difficulties in end-of-life care and educational needs of intensive care unit nurses: a mixed methods study. The Korean Journal of Hospice and Palliative Care. 2019;22(2):87-99. https://doi.org/10.14475/kjhpc.2019.22.2.87
http://dx.doi.org/10.14475/kjhpc.2019.22.2.87
Lee MS, Kim YJ. Good death recognized by the elderly. The Journal of the Korea Contents Association. 2013;13(6):283-299. https://doi.org/10.5392/jkca.2013.13.06.283
http://dx.doi.org/10.5392/jkca.2013.13.06.283
Lee GJ, Park YS. Nurses' spirituality and attitude toward terminal care in geriatric hospital. 2015;13(12):347-357. https://doi.org/10.14400/JDC.2015.13.12.347
http://dx.doi.org/10.14400/JDC.2015.13.12.347
Hardin M, Anderson D, Rexford T. Evaluation of self-efficacy and confidence levels among newly graduated nurses exposed to an end-of-life simulation: a comparison study. Journal of Hospice & Palliative Nursing. 2020;22(6)504-511. DOI: 10.1097/NJH.0000000000000698
http://dx.doi.org/10.1097/NJH.0000000000000698
Ono W. Relationships among actions, antecedents, and outcomes of grief care for bereaved caregivers: surveying visiting nurses throughout Japan. Japan Journal of Nursing Science. 2013;10(2):212-222. https://doi.org/10.1111/jjns.12000
http://dx.doi.org/10.1111/jjns.12000
Teruya N, Sunagawa Y, Sunagawa H, Toyosato T. Visiting nurses' perspectives on practices to achieve end-of-life cancer patients' wishes for death at home: A qualitative study. Asia-Pacific journal of oncology nursing. 2019;6(4):389-396. https://doi.org/10.4103/apjon.apjon_18_19
http://dx.doi.org/10.4103/apjon.apjon_18_19
Hwang MS, Park HY, Chang SJ. Difficulties and coping experienced by advanced practice nurses in home health nursing field. Journal of Korean Academy of Community Health Nursing. 2020;31(2):143-155. https://doi.org/10.12799/jkachn.2020.31.2.143
http://dx.doi.org/10.12799/jkachn.2020.31.2.143
Lim, JY, Kim JH. Expansion strategy of home visit nursing services of long-term care insurance. Journal of Korean Academic Society of Home Health Care Nursing. 2020;27(3):241-249. https://doi.org/10.22705/jkashcn.2020.27.3.241
http://dx.doi.org/10.22705/jkashcn.2020.27.3.241
Choi JS, Jin DB, Lee M, Ko JA. Evaluation of the effectiveness of the first pilot project for home-type hospice palliative care and improvement measures. Research report. Wonju: Health Insurance Review & Assessment Service; 2018 March. Report No.: G000K39-2018-25 https://repository.hira.or.kr/handle/2019.oak/1535.
Kim SH, Jang SN. A study on death perception of home visiting nurses. Journal of Qualitative Inquiry 5.2(2019):89-130 https://doi.org/10.30940/jqi.2019.5.2.89
http://dx.doi.org/10.30940/jqi.2019.5.2.89