중환자실 간호사의 좋은 죽음인식과 윤리적 간호역량이 임종간호수행에 미치는 영향 = The Impact of ICU Nurses’ Perceptions of a Good Death and Ethical Nursing Competence on End-of-Life Care Performance

국문 초록 (Abstract)

본 연구는 중환자실 간호사의 좋은 죽음인식, 윤리적 간호역량, 임종간호수행 정도를 파악하고 이들 변수 간의 관계를 규명하며 임종간호수행에 영향을 미치는 요인을 파악하기 위한 서술적 상관성 연구이다.
본 연구는 C시에 소재한 종합병원 5곳의 중환자실에서 근무하는 임상 경력 6개월 이상 간호사를 대상으로 하였다. 자료 수집은 2025년 6월 30일부터 8월 1일까지 실시하였으며 총 201부가 자료 분석에 사용되었다. 좋은 죽음인식은 Schwartz 등(2003)이 개발한 좋은 죽음 측정 도구를 정현숙(2010)이 번역한 도구를 사용하여 측정했으며, 윤리적 간호역량은 강보라와 오희영(2020)이 개발한 윤리적 간호역량 자가 평가도구를 사용하여 측정하였다. 임종간호수행은 박순주와 최순희(1996)가 개발한 도구를 중환자실 환경에 적절하도록 수정하여 측정하였다.
수집된 자료는 SPSS/WIN ver 27.0 통계프로그램을 사용하여 빈도와 백분율, 평균과 표준편차, Independent t-test,one-way ANOVA, Pearson’s correlation coefficient, 다중회귀분석을 이용하여 분석하였다.
본 연구의 주요 결과를 요약하면 다음과 같다.
1. 중환자실 간호사 201명 중 169명(84.1%)이 1년 이내 임종간호수행 경험이 있는 것으로 나타났다. 임종간호수행 횟수는 평균 7.45±6.26회로 1∼5회가 93명(55.0%)으로 가장 많게 나타났다.
2. 중환자실 간호사의 좋은 죽음인식 점수는 평균 2.98±0.35점, 윤리적 간호역량은 평균 3.21±0.32점이었고 임종간호수행은 평균 2.98±0.37점이었다.
3. 중환자실 간호사의 좋은 죽음인식은 성별에 따라 유의한 차이를 보였으며(t=-2.06, p=.040), 윤리적 간호역량은 1년 이내 임종간호수행 경험에 따라 유의한 차이를 보였다(t=2.54, p=.014). 대상자의 임종간호수행은 임상 경력에 따라 유의한 차이를 보였으며, 사후검정 결과 3∼4년이 10년이상보다 임종간호수행이 유의하게 높게 나타났다(F=3.09, p=.028).
4. 임종간호수행은 좋은 죽음인식(r=.33, p〈.001), 윤리적 간호역량(r=.62,p〈.001)과 유의한 정적 상관관계가 있는 것으로 나타났다.
5. 회귀분석 결과, 임종간호수행에 유의한 영향을 미치는 변인은 윤리적 간호역량(β=.56, p〈.001)과 좋은 죽음인식(β=.13, p=.028)으로 나타났으며,이에 대한 설명력은 40.2%로 나타났다(F=27.91, p〈.001).
본 연구 결과를 통하여 좋은 죽음인식 및 윤리적 간호역량이 임종간호수행에 영향을 미치는 것을 확인하였다. 이러한 결과는 중환자실 간호사의 좋은 죽음인식 및 윤리적 간호역량 강화를 통해 임종간호수행을 높일 수 있음을 시사한다. 따라서 중환자실 간호사의 임종간호수행을 향상시키기 위해서는 좋은 죽음인식에 대한 올바른 인식과 윤리적 간호역량을 증진할 수 있는 프로그램 및 교육 개발이 필요하다. 본 연구는 향후 임종간호수행 증진을 위한 교육 프로그램 및 중재 개발에 기초자료로 활용될 수 있을 것이다.

목차 (Table of Contents)

• Ⅰ.서론
• 1.연구필요성·································································································1
• 2.연구목적·····································································································4
• 3.용어정의·····································································································5
• Ⅱ.문헌고찰
• 1.중환자실간호사의좋은죽음인식·························································7
• 2.중환자실간호사의윤리적간호역량···················································10
• 3.중환자실간호사의임종간호수행·························································13
• Ⅲ.연구방법
• 1.연구설계···································································································16
• 2.연구대상···································································································16
• 3.연구도구···································································································17
• 4.윤리적고려·······························································································19
• 5.자료수집방법·························································································19
• 6.자료분석방법···························································································20
• Ⅳ.연구결과
• 1.대상자의일반적특성·············································································22
• 2.좋은죽음인식,윤리적간호역량및임종간호수행정도················24
• 3.일반적특성에따른좋은죽음인식,윤리적간호역량,
• 임종간호수행차이··················································································26
• 4.좋은죽음인식,윤리적간호역량과임종간호수행의상관관계······30
• 5.임종간호수행에영향을미치는요인···················································31
• Ⅴ. 논의·············································································································· 33
• Ⅵ. 결론 및 제언
• 1. 결론············································································································· 40
• 2. 제언············································································································· 41
• 참고문헌············································································································· 42
• 부록····················································································································· 52
• ABSTRACT····································································································63