[논문]가정전문간호사가 실무에서 경험한 어려움과 대처

황문숙; 박학영; 장수정

doi:10.12799/jkachn.2020.31.2.143

[국내논문] 가정전문간호사가 실무에서 경험한 어려움과 대처
Difficulties and Coping Experienced by Advanced Practice Nurses in Home Health Nursing Field 원문보기

지역사회간호학회지 = Journal of korean academy of community health nursing, v.31 no.2, 2020년, pp.143 - 155

황문숙 (우석대학교 간호대학) , 박학영 (서울아산병원 가정간호사업실) , 장수정 (국립강릉원주대학교 간호학과)

Abstract ▼ AI-Helper

Purpose: This study aimed to explore the difficulties and coping that advanced practice nurses (APNs) experience in home health nursing field. Methods: The participants were 12 APNs who had experience in home health nursing for over 5 years. Data were collected through two focus group interviews between August and September, 2017. The results were analyzed using a qualitative content analysis. Results: Out of 10 sub-categories and 29 codes, 4 categories emerged: "crushed by the responsibilities as the only healthcare professional", "worn out by family who interfere with work", "anxiety about my safety being threatened" and "using self-learned know-hows". Conclusion: APNs face difficulties due to the environmental characteristics of the homes, the characteristics of chronically critically ill (CCI) patients and their families, and legal or systematical limitations when dealing with problems based on their personal competence. In order to ensure that professional nursing care is more readily provided to CCI patients through home health nursing services in local communities, it is imperative that support systems at the organizational and institutional levels be established in a systematic way to resolve the issues faced by APNs.

Keyword

질의응답

핵심어	질문	논문에서 추출한 답변
	질적 내용분석이란 무엇인가?	자료분석을 위해 질적 내용분석(content analysis)을 이용하였다. 이 방법은 특정 현상을 경험한 참여자의 관점을 이해한 다는 질적 접근의 포괄적인 철학적 배경과 면담과 관찰을 통해 나온 자료는 연구자와 참여자간 상호작용에서 형성된다는 의사소통이론을 바탕에 두고[21], 참여자가 나타낸 언어, 행동, 태도, 실제 동기가 반영된 자료 자체에 초점을 두는 귀납적 분석방법이다[20].
	가정전문간호사들의 직무 스트레스가 상당히 높은 이유는 무엇인가?	즉, 가정전문간호사는 가정을 방문해서 예상하고 준비했던 것과 다른 응급상황이 발생하면 자신만의 임상적 판단과 기술로 대처해야 하는 경우가 종종 발생한다[6]. 가정이라는 환경은 응급상황에 대처할 수 있는 안전장치가 없기 때문에 가정전문간호사가 감당하기 어려운 상황에 처할 수 도 있으며[5], 문제 발생 시 가정전문간호사 개인의 자질에 전적으로 의존하게 되어 책임에 대한 갈등을 겪거나 사고에 대한 부담을 갖는다[7]. 이러한 점 때문에 가정전문간호사들의 직무 스트레스수준이 상당히 높은 것으로 알려져 왔다[6,8].
	가정전문간호사의 업무는 무엇인가?	그중 가정간호는 병원의 장기입원을 완화시키고, 병상회 전율을 높여 병원입원에 대한 국민의 의료요구 충족과 의료비용 경감을 위한 목적으로 2001년에 도입되어[2], 2019년 기준 180곳의 의료기관에서 가정간호를 제공하고 있으며, 2017년 까지 6,484명의 가정전문간호사가 배출되었다[3]. 가정전문간호사는 가정간호대상자 가정을 방문하여 일반간호를 제공하는 것은 물론, 검체 채취 및 운반, 투약, 주사, 응급처치 등에 대 한 교육 및 훈련, 상담, 다른 보건의료기관으로의 건강관리에 관한 의뢰 등의 업무와 대상자 및 가족과 치료적 관계를 형성하여 건강관리자, 지지자, 옹호자, 상담자 역할을 담당하고 있다[2]. 그 결과 환자들의 재입원, 응급실 이용, 30일 내 재입원, 건강비용 등이 감소되었고, 환자들의 신체적 기능과 삶의 질 또한 개선되었다[4].

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