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최원자,최희강,박승혜,정헤선,문미혜,곽은영,김옥수,강혜숙,최미리 병원간호사회 1999 임상간호연구 Vol.4 No.2
The pattern of causes of death and diseases has been changed with the environmental pollution due to industrialization and increase of population. As medical technology has developed and expected life year is longer, the chronically ill patients have increased. The nurses have had more opportunities to care for these dying people and increased the interest in nursing care for them. Dying people have the physical, mental, social, spiritual problems including pain, anxiety, fear and frustration, restlessness, helplessness, loneliness and need the help to cope with the situations. The care should include encouragement and support of the family as well as the dying individuals to cope with reality effectively. Most nurses who have cared for the dying people have experienced emotional stress such as sorrow, embarrassment, anger, depression, powerlessness, uncontrollability, hopelessness, loss, and had no educational preparation and support to deal with that. As a result, the stress made the nurses who have cared for the dying people impaired mentally or physically, and caused the burnout. This study tries to identify the experience of nurses who cared for the dying people and explore the interventions to manage the situation more effectively using the qualitative-phenomenological approach which describe inductively the cognitive experience of nurses in caring for the dying people and formulate theoretical themes systematically. We consulted the research methodology to a nursing professor who majored in qualitative research. The study subject is ten convenient-sampled staff nurses who agreed to participate in this study, selected by recommendations of head nurses that conduct this research. The data were collected from June 19 to August 7, 1998 by eight head nurses using the interview with open, semiconstructed questionnaires. All data were recorded by cassette tapes and then the interviewer transcripted the recorded data after interview. The data were analyzed by Colaizzi's method. At first 524 significant statements reflecting the nurses' experiences of caring for dying people were drawn from raw data. From these significant statements, 107 formulated meanings were concluded. Finally we identified six themes from these formulated meanings. Throughout the research process, the relevance between constructed statements and raw data was reviewed. The identified themes are as follows : Nurses who have cared for the dying people experienced the burden of ethical, legal responsibilities that they should professionally maintain the life of patient and support their family by implementing physical, psychological, spiritual nursing care. They have heartbrokening, experiencing the empathy and pity to patients and their families. The nurses that have experienced more opportunities of caring for dying people tend to have work-oriented characteristics and cope more objectively. However, all nurses experienced a great deal of burden and expressed freedom and easiness with loss and grief when the patients died. They narrated the process of caring for dying person has made them mature in life, realizing the meaning of life, thinking their own death, respecting the life and losing the avarice. The most important of six themes in nursing is burden. Further study need to conduct as an effort to relieve the nurses' burden. At last, we validated our result by ten interviewees' reviewing the correspondence between the descriptive statements and their experiences.
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