Jeong, Da-In
(Department of Nursing, Gyeongsang National University Hospital)
,
Eun, Young
(College of Nursing, Institute of Health Sciences, Gyeongsang National University)
Purpose: The purpose of this study was to investigate the levels of end-of-life care competency; knowledge, attitudes, and experiences regarding advance directives; perceptions of good death; and end-of-life care obstacles and supportive behaviors among tertiary care nurses. Methods: The participant...
Purpose: The purpose of this study was to investigate the levels of end-of-life care competency; knowledge, attitudes, and experiences regarding advance directives; perceptions of good death; and end-of-life care obstacles and supportive behaviors among tertiary care nurses. Methods: The participants were 150 nurses at a tertiary hospital in Jinju, Korea. The data collected using a questionnaire were analyzed using descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and stepwise multiple regression in SPSS for Windows version 24.0. Results: The mean (±SD) score of end-of-life care competency was 3.63 (±0.53) on a 5-point scale. A significant difference in end-of-life care competency was found according to whether nurses had experienced the death of a family member or acquaintance (P=0.029). According to stepwise multiple regression analysis, the factors affecting end-of-life care competency were the frequency of end-of-life care supportive behaviors (β=0.38, P<0.001), experience with advance directives (β=0.29, P<0.001), and marriage (β=0.15, P=0.039). This model had an explanatory power of 27.9% (F=18.87, P<0.001). Conclusion: In order to improve nurses' end-of-life care competency, it is important to strengthen end-of-life care supportive behaviors by exposing nurses to those behaviors and providing frequent experience with advance directives.
Purpose: The purpose of this study was to investigate the levels of end-of-life care competency; knowledge, attitudes, and experiences regarding advance directives; perceptions of good death; and end-of-life care obstacles and supportive behaviors among tertiary care nurses. Methods: The participants were 150 nurses at a tertiary hospital in Jinju, Korea. The data collected using a questionnaire were analyzed using descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and stepwise multiple regression in SPSS for Windows version 24.0. Results: The mean (±SD) score of end-of-life care competency was 3.63 (±0.53) on a 5-point scale. A significant difference in end-of-life care competency was found according to whether nurses had experienced the death of a family member or acquaintance (P=0.029). According to stepwise multiple regression analysis, the factors affecting end-of-life care competency were the frequency of end-of-life care supportive behaviors (β=0.38, P<0.001), experience with advance directives (β=0.29, P<0.001), and marriage (β=0.15, P=0.039). This model had an explanatory power of 27.9% (F=18.87, P<0.001). Conclusion: In order to improve nurses' end-of-life care competency, it is important to strengthen end-of-life care supportive behaviors by exposing nurses to those behaviors and providing frequent experience with advance directives.
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문제 정의
The participants of this study were nurses working at a tertiary hospital in J city, South Gyeongsang Province, South Korea who had more than 6 months of clinical experience and who provided written informed consent after indicating that they understood the aim of the study.
Therefore, this study investigated nurses’ end-of-life care competency; knowledge, attitudes, and experiences regarding advance directives; perceptions of good death; barriers to end-of-life care; and supportive behaviors, with the goal of enhancing their end-of-life care competency and improving the quality of end-of-life care of nurses.
제안 방법
In order to examine the factors that influence end-of-life care competency, general characteristics that demonstrated significant differences (marital status, experience in end-of-life care, and having experienced the death of a family member or acquaintance); knowledge, attitudes, and experiences regarding advance directives; perceptions of a good death; intensity, frequency, and PIS of end-of-life care obstacles; and intensity, frequency, and PSBS of end-of-life care supportive behaviors were analyzed as independent variables in simple regression analyses. The frequency of end-of-life care supportive behaviors, experience with advance directives, and marital status were found to influence the end-of-life care competency among participants, and the regression model explained 27.
In order to examine the factors that influenced end-of-life care competency, general characteristics that demonstrated a significant difference (marital status, experience of end-of-life care, and having experienced the death of a family member or acquaintance); knowledge, attitudes, and experiences regarding advance directives; perceptions of a good death; intensity, frequency, and PIS of end-of-life care obstacles; and intensity, frequency, and PSBS of end-of-life care supportive behaviors were analyzed as independent variables in simple regression analyses (Table 4).
Third, the variance explained by the factors that influence end-of-life care competency in this study was not at a satisfactory level. In order to improve the proportion of variance explained, another study with an expanded list of factors that influence end-of-life care competency is warranted.
The researcher visited the department to explain the aim and purpose of the study and received written approval for data collection from the department head. The aim and purpose of the study were also explained to the head nurses of each ward, and the participants completed the survey after providing written consent to participate in the study voluntarily upon reading the consent form that contained an explanation on the aim of the study, duration of the study, and protection of data. Participants were notified that they could discontinue their participation at any point during the survey, and those who completed the survey received a small token of appreciation.
The aim of this study was to obtain insights into end-of-life care competency; knowledge, attitudes, and experiences regarding advance directives; perceptions of good death; barriers to end-of-life care; and supportive behaviors among nurses at tertiary hospitals and to examine factors that influence end-of-life care competency.
The tool contains 17 items distributed across three subdomains (familiarity, sense of control, and clinical symptoms), and uses a 4-point Likert scale from “not important at all” (1) to “very important” (4).
This study examined nurses’ end-of-life care competency; knowledge, attitudes, and experiences regarding advance directives; perceptions of a good death; and end-of-life care obstacles and supportive behaviors, and investigated factors associated with end-of-life care competency.
대상 데이터
90, and six predictors (total number of predictors: 13) was 123. Considering the expected dropout rate, 150 surveys were distributed and all 150 were collected. There were no surveys with missing data; therefore, all 150 surveys were used for the final data analysis.
The tool consists of 28 items with 5-point Likert scale ranging from “not applicable” (0) and “not at all” (1) to “always” (5), and higher scores indicate higher end-of-life care competency.
This study was approved by the G University Hospital Clinical Research IRB (2019-05-017-001) and the Department of Nursing, and data was collected at the department from September 1 to 10, 2019 with clinical nurses as participants. The researcher visited the department to explain the aim and purpose of the study and received written approval for data collection from the department head.
데이터처리
2) Differences in end-of-life care competency by participants’ general characteristics were analyzed with the independent t-test and one-way analysis of variance.
3) Stepwise multiple regression analysis was performed to identify the factors that influenced end-of-life care competency of participants.
성능/효과
In this study, the mean score for end-of-life care competency among participants was 3.63±0.53 out of 5.
In order to examine the factors that influence end-of-life care competency, general characteristics that demonstrated significant differences (marital status, experience in end-of-life care, and having experienced the death of a family member or acquaintance); knowledge, attitudes, and experiences regarding advance directives; perceptions of a good death; intensity, frequency, and PIS of end-of-life care obstacles; and intensity, frequency, and PSBS of end-of-life care supportive behaviors were analyzed as independent variables in simple regression analyses. The frequency of end-of-life care supportive behaviors, experience with advance directives, and marital status were found to influence the end-of-life care competency among participants, and the regression model explained 27.9% of the variance. In Lee [12], communication with and the level of support from patients who discontinued life-sustaining treatments and their family members, which can be understood as similar to frequency of end-of-life supportive behaviors, were found to influence end-of-life care competency.
001) were found to influence the end-of-life care competency of participants. The regression model explained 27.9% of the variance and was statistically significant (F=18.87, P＜0.001) (Table 5).
후속연구
Although this study is meaningful in that it examined end-of-life care competency among nurses at tertiary hospitals and their associations with various factors, it has some limitations. First, since the research on factors that influence end-of-life care competency among nurses in South Korea is not sufficient, additional studies at hospitals of various sizes and in different regions are necessary. Education on advance directives according to the 2018 Act on Decisions on Life-Sustaining Treatment is necessary.
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