학교내 응급상황에 대한 준비 실태와 보건교사의 응급처치 수행자신감 Preparation and Self-Confidence to Response to Emergent, Acute or Life-threatening Health Crisis among School Nurses in South Korea원문보기
배경 및 목적: 본 연구는 학교 내 응급상황(천식 위기, 알레르기 반응, 저혈당 위기, 발작, 심폐정지, 출혈/골절, 머리/목 상해, 열성질환, 중독, 질식)에 대한 행정 차원과 물품구비 차원에서의 준비 실태, 그리고 응급처치 수행자신감을 파악하는데 목적이 있다. 방법: 단면조사연구로 274명의 보건교사를 대상으로 하였으며, 자가보고형 조사지를 이용하여 대상자와 학교의 일반적 특성, 학교 내 응급상황에 대한 행정·물품 준비 실태, 그리고, 응급처치 수행자신감 등 3개 영역의 자료를 수집하였다. 자료수집은 2018년 2월 1일부터 2018년 7월 31일까지 실시하였고, 자료분석은 기술통계, t-검정과 분산분석을 이용하였다. 결과: 대부분의 학교에서 응급상황 관리계획이 있었으나, 응급상황별로 천식 위기는 46.7%, 알레르기 반응은 58.4%에서만 관리계획을 갖추고 있었다. 산소, 혈당측정기, 자동제세동기, 경추고정장치 등은 85% 이상의 학교에서 보유하고 있었으나, 기관확장제 흡입기, 에피네프린 주사제, 흡인기 등은 거의 갖추고 있지 않았다. 응급상황 수행자신감은 5점 만점에 2.67점 (발작관리) 에서 3.55점 (심폐정지관리)이었으며, 일부 응급상황에 대해서 의료기관 근무경력이 증가함에 따라 수행자신감이 증가하였다. 결론: 대부분의 학교에서 응급관리계획을 수립하고 있었으나, 응급상황별 관리계획을 수립한 경우는 반 정도에 불과하였다. 보건교사의 학교 내 응급상황에 대한 응급처치 수행자신감은 전체적으로 낮게 나타남에 따라, 이들의 역량강화를 위한 체계적인 교육과 멘토링 프로그램이 요구된다.
배경 및 목적: 본 연구는 학교 내 응급상황(천식 위기, 알레르기 반응, 저혈당 위기, 발작, 심폐정지, 출혈/골절, 머리/목 상해, 열성질환, 중독, 질식)에 대한 행정 차원과 물품구비 차원에서의 준비 실태, 그리고 응급처치 수행자신감을 파악하는데 목적이 있다. 방법: 단면조사연구로 274명의 보건교사를 대상으로 하였으며, 자가보고형 조사지를 이용하여 대상자와 학교의 일반적 특성, 학교 내 응급상황에 대한 행정·물품 준비 실태, 그리고, 응급처치 수행자신감 등 3개 영역의 자료를 수집하였다. 자료수집은 2018년 2월 1일부터 2018년 7월 31일까지 실시하였고, 자료분석은 기술통계, t-검정과 분산분석을 이용하였다. 결과: 대부분의 학교에서 응급상황 관리계획이 있었으나, 응급상황별로 천식 위기는 46.7%, 알레르기 반응은 58.4%에서만 관리계획을 갖추고 있었다. 산소, 혈당측정기, 자동제세동기, 경추고정장치 등은 85% 이상의 학교에서 보유하고 있었으나, 기관확장제 흡입기, 에피네프린 주사제, 흡인기 등은 거의 갖추고 있지 않았다. 응급상황 수행자신감은 5점 만점에 2.67점 (발작관리) 에서 3.55점 (심폐정지관리)이었으며, 일부 응급상황에 대해서 의료기관 근무경력이 증가함에 따라 수행자신감이 증가하였다. 결론: 대부분의 학교에서 응급관리계획을 수립하고 있었으나, 응급상황별 관리계획을 수립한 경우는 반 정도에 불과하였다. 보건교사의 학교 내 응급상황에 대한 응급처치 수행자신감은 전체적으로 낮게 나타남에 따라, 이들의 역량강화를 위한 체계적인 교육과 멘토링 프로그램이 요구된다.
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문제 정의
It is a basic but vital role of school nurses to provide proper treatment for health crises during the school day (Breena, & Anne, 2016; Toresdahl, Harmon, & Drezner, 2013), but fear, anxiety, and lack of self-confidence in responding to health crises can prevent them to provide active and professional care (Greene, 2019; Stoodley, McKellar, Steen, & Fleet, 2020; Yoon & Lee, 2017). Therefore, this study aimed to identify the preparation in term of administrative and equipment preparation at the school level, and self-confidence of school nurses to respond to emergent, acute or life-threatening health crises on an individual level in South Korea.
To our knowledge, this is the first study to identify preparation and self-confidence of school nurses to respond to emergent, acute or life-threatening health crises in elementary, middle, and high schools and to suggest some recommendations in South Korea. We have especially tried to improve the validity of the response by describing the situations that can be faced in the real world, in the form of scenarios.
제안 방법
We used a self-administered questionnaire developed by Olympia, Wan, & Avner (2005). After obtaining permission from the tool developer, the questionnaire was translated into Korean by two researchers and evaluated validity of vocabulary selection and clarity of meaning by two nurses who were fluent in both Korean and English. It was also culturally adapted by revising the qualification name according to Korean agencies and changing the child’s name to a Korean name in the scenario depicting a health crisis situation.
It was also culturally adapted by revising the qualification name according to Korean agencies and changing the child’s name to a Korean name in the scenario depicting a health crisis situation. And, we added working years at hospitals and some type of special health care needs such as self-glucose monitoring, and removed the question on biochemical disaster preparation to the questionnaire.
The final questionnaire consisted of the general characteristics of schools and school nurses, administrative and equipment preparation for ten emergent, acute and life-threatening health crises in schools (asthma crisis, allergic reaction, diabetic crisis, seizure, cardiopulmonary failure, bleeding/fracture, head/neck injury, heat-related illness, poisoning, and choking), and self-confidence in responding to the health crises. General characteristics included age, educational background, working years in schools and hospitals, type of qualification, school type, number of students in the school, type of special health care needs, and annual incidence of the health crisis.
대상 데이터
5%). Final participants consisted of 181 elementary, 36 middle, 53 high, and 4 special education school nurses.
데이터처리
Self-confidence according to some of the general characteristics of the participants and administrative and equipment preparation was analyzed using t-test and ANOVA, followed by Scheffé’s post-hoc test.
후속연구
Considering that the equipment in schools depends on the Office of Education’s guidance of each province (MGL, 2019a), further studies to compare the results with school nurses in other provinces or other countries are recommended.
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