선택한 단어 수는 입니다.
최소 단어 이상 선택하여야 합니다.
최소 단어 이상 선택하여야 합니다.
선택한 단어 수는 30입니다.
최대 10 단어까지만 선택 가능합니다.
최대 10 단어까지만 선택 가능합니다.
문제 정의
- Therefore, this study aimed to determine the factors affecting compassion fatigue among nurses working at specialized hospice and palliative care facilities. Furthermore, we sought to provide basic data for the development of interventions to prevent compassion fatigue among nurses working at specialized hospice and palliative care facilities.
- This study was conducted to investigate relationships between nursing workplace spirituality, end-of-life care stress, resilience, and compassion fatigue among nurses working at specialized hospice and palliative care facilities and to examine the effects of these variables on compassion fatigue among them, thereby providing basic data for the development of interventions to prevent compassion fatigue among nurses working at specialized hospice and palliative care facilities.
제안 방법
- For data collection, the researchers explained the purpose and process of the research to the head of the relevant medical institutions and obtained consent from the study partici- pants, after which the participants were asked to directly fill out structured, self-reported questionnaires. Data were collected from February 25, 2019, to April 12, 2019, and the data collection method was approved by the Institutional Review Board of K University in B Metropolitan City (IRB number: KU IRB 2018-0103).
- In order to determine the factors influencing the participants’ compassion fatigue, stepwise multiple regression analysis was performed on the following general characteristics that were associated with compassion fatigue levels: age, work experi- ence, marital status, religiosity, bereavement experience within the last 1 year, current hospice ward satisfaction, the frequency of end-of-life care experience, subjective health status, nursing workplace spirituality, end-of-life care stress, and resilience. The most explanatory variable for compassion fatigue was resilience (β=-0.
- It is a 40-item assessment tool consisting of 7 subscales, including negative attitudes of patient and his/her family members, difficulty of sharing time to the dying patient, burden about bereavement care, overloaded duty, humane relation conflict with dying patient, insufficiency in professional knowledge and skills, and conflict about medical limit. The tool uses a 5-point Likert scale, and a higher score indicates higher end-of-life care stress.
- Data were collected from February 25, 2019, to April 12, 2019, and the data collection method was approved by the Institutional Review Board of K University in B Metropolitan City (IRB number: KU IRB 2018-0103). The questionnaire used for data collection included information on the study purpose, study participation period, procedures and methods, expected risks and benefits, personal data protection, compensation for losses associated with participation in the study, and withdrawal of consent. Written consent was obtained and voluntary participation was guaranteed from an ethical standpoint.
- The tool has a total of 32 items and is composed of six subscales including interaction with job environment, meaning of nursing, inner self, relationship with colleagues, harmony between workplace and individual, and transcendence through nursing. It uses a 7-point Likert scale, and a higher score indicates higher nursing workplace spirituality.
- This descriptive correlational study was conducted to identify the factors affecting compassion fatigue among nurses at specialized hospice and palliative care facilities.
대상 데이터
- 80, and 14 predictive factors assumed considering the 11 items on general characteristics and three independent variables, the minimum sample required was 135 people. Considering the potential for dropout, 149 questionnaires were distributed, of which 146 copies, excluding three with insufficient responses, were used for the final analysis.
- structured, self-reported questionnaires. Data were collected from February 25, 2019, to April 12, 2019, and the data collection method was approved by the Institutional Review Board of K University in B Metropolitan City (IRB number: KU IRB 2018-0103). The questionnaire used for data collection included information on the study purpose, study participation period, procedures and methods, expected risks and benefits, personal data protection, compensation for losses associated with participation in the study, and withdrawal of consent.
- 0), which is a revised and supplemented version of the original tool developed by Figley [20]. The tool used in this study consists of a total of 20 items and includes two subscales (secondary traumatic stress and burn- out). The tool uses a 5-point Likert scale, and higher scores indicate higher levels of compassion fatigue.
- the Ministry of Health and Welfare. They were selected using convenience sampling from 14 medical institutions nationwide (1 in city A, 1 in city An, 4 in city B, 2 in city C, 3 in city D, 1 in city G, 1 in city S, and 1 in city U) of the total 85 inpatient hospice and palliative care facilities registered with the Ministry of Health and Welfare. The study participants were those who understood the purpose of the study and consented to voluntary participation, had worked at a specialized hospice and palliative care facility for 6 months or more, had experience of end-of-life care, and completed 60 hours or more of hospice education recognized by the Ministry of Health and Welfare.
데이터처리
- 2) Differences in the degree of compassion fatigue by general characteristics of the participants were analyzed by the t-test and analysis of variance, and a post-hoc analysis was performed using the Scheffé test.
- 3) Relationships between participants’ nursing workplace spirituality, end-of-life care stress, resilience, and compassion fatigue were analyzed using Pearson correlation coefficients.
- 4) Stepwise multiple regression was performed to identify factors affecting compassion fatigue.
이론/모형
- Compassion fatigue was assessed using a tool described by Kim [19], who adapted Stamm’s [3] Professional Quality of Life Scale version 5.0 (ProQOLS: Compassion Satisfaction/ Fatigue Subscale-version 5.0), which is a revised and supplemented version of the original tool developed by Figley [20]. The tool used in this study consists of a total of 20 items and includes two subscales (secondary traumatic stress and burn- out).
- Nursing workplace spirituality was assessed using a measurement tool that Suk and Koh [12] developed for this pur- pose. The tool has a total of 32 items and is composed of six subscales including interaction with job environment, meaning of nursing, inner self, relationship with colleagues, harmony between workplace and individual, and transcendence through nursing.
- Resilience was assessed using the tool proposed by Choi and Seok [22]. They modified the Korean Resilience Quotient-53 (KRQ-53) to use among adults, which Shin et al.
- It is a 40-item assessment tool consisting of 7 subscales, including negative attitudes of patient and his/her family members, difficulty of sharing time to the dying patient, burden about bereavement care, overloaded duty, humane relation conflict with dying patient, insufficiency in professional knowledge and skills, and conflict about medical limit. The tool uses a 5-point Likert scale, and a higher score indicates higher end-of-life care stress. Lee and Lee [14] reported the total Cronbach’s α was 0.
성능/효과
- 1) General characteristics, nursing workplace spirituality, end-of-life care stress, resilience, and compassion fatigue were analyzed by descriptive statistics such as percentage, mean, and standard deviation.
- First, regarding work spirituality, end-of-life care stress, resilience, and compassion fatigue among nurses working at specialized hospice and palliative care facilities, the mean score for the level of work spirituality among the nurses at specialized hospice and palliative care facilities was 4.93 points (out of 7 points), which is somewhat higher than the scores of 4.49 points among general hospital nurses reported by Kown and Oh [23], 4.59 points reported by Suk and Koh [12], and 4.13 points among hospital nurses reported by Jin et al. [9].
- In this study, besides resilience, subjective health status and hospice ward satisfaction were found to have the strongest influence on compassion fatigue among nurses at specialized hospice and palliative care facilities. It is difficult to make a direct comparison due to the scarcity of research on factors influencing compassion fatigue among nurses at specialized hospice and palliative care facilities, but a similar finding was reported in a study involving intensive care unit nurses [29], in whom subjective health status affected burnout, a subscale of compassion fatigue.
- In this study, the factors affecting the level of compassion fatigue among nurses at specialized hospice and palliative care facilities were resilience, subjective health status, current hospice ward satisfaction, and end-of-life care stress, with an overall explanatory power of 42.9%. Specifically, higher re- silience, higher current hospice ward satisfaction, a subjective perception of good health, and lower end-of-life care stress were associated with lower levels of compassion fatigue.
- The most robust explanatory factor for compassion fatigue among nurses at specialized hospice and palliative care facilities was resilience. Due to the lack of research on the factors affecting compassion fatigue among nurses at specialized hospice and palliative care facilities, it is difficult to directly compare the results of this study, but resilience was also reported to be the most explanatory factor of burnout, a subscale of compassion fatigue, among clinical nurses in a study of Ryu and Kim [17].
후속연구
- In addition, it is necessary to understand the characteristics of compassion fatigue among nurses at specialized hospice and palliative care facilities through additional studies on factors affecting compassion fatigue among these nurses. A practical compassion fatigue prevention program should be developed for nurses at specialized hospice and palliative care facilities based on comparative studies on compassion fatigue involving nurses who work at specialized facilities to provide home or outpatient hospice care, as well as inpatient hospice care.
- By contrast, the results reported by Kim and Yong [28] are contradictory to the findings observed in our study: although the participants were not nurses, they found that among adult workers aged 20 years or older, workplace spirituality affected burnout, a sub scale of compassion fatigue. Therefore, in order to determine whether these conflicting results were due to differences in wards or occupations, further studies should explore the effect of nursing workplace spirituality on compassion fatigue among nurses at specialized hospice and palliative care facilities. In addition, it is our understanding that the conceptual similarity of the subscales of resilience and nursing workplace spirituality contributed to our findings that nursing workplace spirituality was correlated with compassion fatigue, but did not influence it.
- Therefore, it appears that resilience is a broader concept than nursing workplace spirituality and has a greater effect on compassion fatigue. Therefore, in the future, it will be necessary to confirm the similarity between these two concepts (nursing workplace spirituality and resilience) and conduct additional studies among nurses at specialized hospice and palliative care facilities to confirm the results of the current study.
- 17 points). This suggests that there may be some differences in the factors that cause stress in end-of- life care depending on the ward environment, and it is thus necessary to perform additional studies to further verify these differences. In the current study, the highest score was found for stress related to “negative attitudes of patient and his/her family members”, which refers to their denial of the condition and imminent death [14].
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