중환자실 간호사의 환자안전사고 소통하기에 대한 인식과 의사소통 장애 간의 관계

조인선,최수정,Cho, In Sun,Choi, Su Jung 한국중환자간호학회 2024 중환자간호학회지 Vol.17 No.1

Purpose : This study sought to explore intensive care unit (ICU) nurses' perceptions regarding the disclosure of patient safety incidents (DPSI) and identify the relationship between the perception of DPSI and communication barriers. Methods : This study used a descriptive research design. A total of 110 ICU nurses from a tertiary hospital were surveyed online between September 14 and October 5, 2022. The mean DPSI score ranged between 1.0 and 4.0, with a higher score indicating a higher perception of DPSI. Results : The mean score for ICU nurses' perceptions of DPSI was 2.92 (SD=0.37). Among the characteristics of ICU nurses, differences were observed in perceptions of DPSI according to gender, age, total work experience, and ICU work experience. Communication barriers among ICU nurses were negatively correlated with negative results as a sub-factor of perceptions of DPSI. Ambiguity in the nurse's position, lack of confidence, differences in perspectives with patients, and inadequate nurse-patient relationships as sub-factors of communication barriers exhibited a negative correlation with negative results as a sub-factor of perceptions of DPSI. Conclusions : ICU nurses' perceptions of DPSI and the sub-factors related to communication barriers are negatively related to DPSI. To improve ICU nurses' perceptions, open and non-punitive circumstances, staff education, practical guidelines, and support systems are required.

중환자실 간호사의 대상자 중심(Patient Centered) 의사소통 역량수준 및 관련요인

박영수,오의금,Park, Young-Su,Oh, Eui Geum 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.2

Purpose : This study aimed to provide primary data for developing a program to enhance communication competence by identifying the patient-centered communication competency level of Intensive Care Unit (ICU) nurses and the related factors. Method : Data were collected from August 28th to October 8th, 2015, from 199 ICU nurses working in 30 tertiary hospitals. The study questionnaire included items assessing the patient-centered communication competency of ICU nurses, nursing organizational culture, types of communication, the Teamwork Measurement Tool, the Perceived Nursing Work Environment tool, and the Wong & Law Emotional Intelligence Scale. The collected data were analyzed using descriptive statistics, a correlation test, and a multiple regression. Results : The ICU nurses' mean score on patient-centered communication competency was 3.97 points. The factors influencing the patient-centered communication competency level of ICU nurses were professionalism (p =.002), innovation-oriented organizational culture (p =.015), and emotional intelligence (p<.001). These variables explained 42.2% of the total variance in the patient-centered communication competency of ICU nurses. Conclusion : These findings suggest the need for developing a patient-centered communication competency improvement program that focuses on improving ICU nurses' professionalism and emotional intelligence, and facilitates the creation of an innovation-oriented organizational culture.

중환자실 간호사의 전문직자율성, 의사소통만족도, 회복탄력성이 직무만족도에 미치는 영향

박은진,이윤미,Park, Eun Jin,Lee, Yun Mi 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.2

Purpose : This study aimed to identify the factors influencing job satisfaction in intensive care unit (ICU) nurses. Method : Using a cross-sectional design, data collected from 145 ICU nurses working at two university hospitals with more than 1,200 beds located in B and Y city were analyzed. The instruments used for this study assessed autonomy, communication satisfaction, resilience, and job satisfaction. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple linear regression analysis. Results : Job satisfaction was significantly correlated with communication satisfaction (r=.60, p < .001) and resilience (r=.34, p < .001). Further, job satisfaction was influenced by communication satisfaction (${\beta}=.48$, p < .001), working at a surgery ICU (${\beta}=.21$, p =.008), and dissatisfaction with nursing (${\beta}=-.24$, p =.005). The explanatory power of this model was 44.7%. Conclusion : These results suggest the need for programs to improve communication satisfaction and nursing satisfaction.

통합적 고찰과 키워드 분석을 이용한 최근 10년(2008-2017) 동안의 국내 중환자간호 연구 동향 분석

강지연,김수경,조영신,고현영,백지현,이수진,Kang, Jiyeon,Kim, Soo Gyeong,Cho, Young Shin,Ko, Hyunyoung,Back, Ji Hyun,Lee, Su Jin 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.2

Purpose : The purpose of this study was to examine the possible direction of critical care nursing research in the future by analyzing the trends of recent Korean studies. Method : Using a database search, we selected 263 articles on critical care nursing that were published in Korean journals between 2008 and 2017. Then, we conducted an integrative review of the contents of the selected articles and analyzed the English abstracts using the relevant packages and functions of the R program. Results : The number of studies concerning critical care nursing has increased over the 10-year period, and the specific topic of each study has diversified according to the time at which it was conducted. In terms of quality, the majority of the research was published in high-level academic journals. The key words regularly studied over the past decade were: knowledge, delirium, education, restraint, stress, and infection. Studies related to vancomycin-resistant enterococci infection, compliance, and standards have decreased, while studies related to death, communication, and safety have increased. Conclusion : Randomized controlled trials and protocol research for evidence-based critical care need to be conducted, as does research on family involvement. The key word analysis of unstructured text used in this study is a relatively new method; it is suggested that this method be applied to various critical care nursing research and develop it methodologically.

중환자실의 욕창 예방 중재 프로그램의 효과 : 메타 분석

강현욱,고지운 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.1

Purpose : A meta-analysis was conducted to identify the effectiveness of strategies designed to prevent the incidence and prevalence of pressure ulcers in intensive care units (ICUs). Method : The search strategy was designed to retrieve studies both published and unpublished between 2007 and 2017 including studies in English across PubMed and CINAHL, as well as in Korean across RISS, DBPia, NDSL, KISS, and NAL. All adult ICU participants were 18 years or over. Inclusion criteria were randomized controlled trials, quasi-experimental and comparative studies. Two independent reviewers conducted quality assessments of the included studies by Scottish Intercollegiate Guidelines Network. A Review Manager 5 was used to analyze effect sizes and to identify possible sources of heterogeneity among the studies. Results : The odds ratio (OR) effect sizes were all statistically significant. The OR of total effect size was 0.30(95% CI: 0.19, 0.47), care bundle was 0.37(95% CI: 0.24, 0.57), position change was 0.45(95% CI: 0.10, 2.08), and a silicone border foam dressing was 0.14 (95% CI: 0.07, 0.29). Conclusion : The preventive interventions for patients in the ICUs have positive impacts on reducing the incidence of pressure ulcers.

집중치료 후 증후군의 신체적 장애 측정도구에 관한 체계적 고찰

강지연,이민주,정연진,김수경,조영신,박정훈,이순영,홍지원 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.1

Purpose : The purpose of this study was to systematically review the instruments utilized to assess physical impairment in post-intensive care syndrome (PICS) of intensive care unit (ICU) survivors. Method : Online databases searched were MEDLINE, Cochrane, CINAHL, and Embase. Studies that met the following criteria were included: 1) the study population exclusively had experience with ICU admission; 2) the study assessed pulmonary, neuromuscular, and physical functions; and 3) the study was published in English language journals after 2007. Results : A total of 56 instruments (2 pulmonary, 25 neuromuscular, 29 physical function) from 94 studies were reviewed. They were classified into self-report, observation, and measurement according to the type of assessment. No instrument measured all 3 areas of physical impairment. Five instruments were originally developed for the ICU patients. The most frequently applied instruments were the Medical Research Council and the 36-item Short Form Survey (physical component summary), which were used in 23 studies each. Only 13.8% of reviewed studies reported the reliability or validity of the instruments. Conclusion : Our results suggest that the appropriateness of instruments assessing physical impairment in PICS cannot be guaranteed. Despite the multidimensional concept of physical disabilities, most studies measured only one area, and studies that reported psychometric properties were limited. Accordingly, we propose to develop a unique and multifaceted instrument for ICU survivors.

질적연구 진술문을 이용한 중환자실 생존자의 감성분석

강지연 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.1

Purpose : As the intensive care unit (ICU) survival rate increases, interest in the lives of ICU survivors has also been increasing. The purpose of this study was to identify the sentiment of ICU survivors. Method : The author analyzed the quotations from previous qualitative studies related to ICU survivors; a total of 1,074 sentences comprising 429 quotations from 25 relevant studies were analyzed. A word cloud created in the R program was utilized to identify the most frequent adjectives used, and sentiment and emotional scores were calculated using the Artificial Intelligence (AI) program. Results : The 10 adjectives that appeared the most in the quotations were ‘difficult’, ‘different’, ‘normal’, ‘able’, ‘hard’, ‘bad’, ‘ill’, ‘better’, ‘weak’, and ‘afraid’, in order of decreasing occurrence. The mean sentiment score was negative (-.31±.23), and the three emotions with the highest score were ‘sadness’(.52±.13), ‘joy’(.35±.22), and ‘fear’(.30±.25). Conclusion : The natural language processing of AI used in this study is a relatively new method. As such, it is necessary to refine the methodology through repeated research in various nursing fields. In addition, further studies on nursing interventions that improve the coherency of ICU memory of survivors and familial support for the ICU survivors are needed.

중환자실간호사의 다제내성균 감염관리지침 수행에 영향을 미치는 요인에관한 경로 분석 ; 계획된 행위이론과 환자안전문화를 중심으로

구지은,하이경,황수호,공경희 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.1

Purpose : The purpose of this study was to analyze factors influencing the adherence to guidelines for intensive care unit (ICU) nurses to control infections due to multidrug-resistant organisms (MDRO). Method : Participants were 194 ICU nurses at 3 university hospitals. Questions for the survey inquired about attitude, subjective norms, perception of patient safety culture to carry out MDRO management guidelines, perceived behavior control (PBC), and intention, based on the theory of planned behavior. Path analysis were utilized. Results : The path analysis presented that PBC, perception of patient safety culture, and intent had a direct effect on MDRO management guidelines. Attitude towards following the manual did not have any correlation. The hypothetical model based on the theory of planned behavior was revealed as applicable; the degree of the variance in explaining adherence to the manual was 23 %, and the variance in explaining intention to fulfill the manual was 33 %. Conclusion : The results of this study suggest that we should develop a program to improve PBC to increase adherence to MDRO management guidelines. ICU nurses’ perceptions of patient safety culture should also be surveyed.

중환자실 환자가 경험한 인간중심 간호에 관한 질적 내용분석

홍희진,강지연,Hong, Hee Jin,Kang, Jiyeon 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.2

Purpose : To explore the person-centered care (PCC) experienced by critical patients. Method : This qualitative study deductively examined the attributes of the PCC model proposed by Jakimowicz and Perry. The participants were 16 patients who were recently discharged from intensive care units at a university hospital. Data were collected through in-depth interviews and were analyzed using the deductive method of content analysis. Results : A total of 4 categories, 16 subcategories, and 33 codes were generated from 171 meaningful statements. The final 4 categories were "compassionate presence," "professional interaction," "outstanding competency," and "patient identity." These were consistent with the main attributes of Jakimowicz and Perry's model. However, most of the codes belonged to the "compassionate presence" and "patient identity" categories. Among the attributes of the model, "continuity of nursing," "therapeutic relationship," "expert knowledge," "clinical knowledge," "evidence-based intervention," and "patient's rights" were not derived as codes. Conclusion : These findings deepen the understanding of the PCC model from the patient's point of view. The main attributes of PCC identified in the current study can be applied to the development of practical guidelines for intensive care nursing. In addition, we recommend the development of a PCC measurement tool for critical care patients.

중환자실 간호사의 임종 환자 돌봄 경험

설은미,고진강,Seol, Eun-Mi,Koh, Chin-Kang 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.2

Purpose : This study aimed to develop an in-depth and comprehensive understanding of the experiences of critical care nurses caring for dying patients. Method : Eleven critical care nurses with experience in caring for dying patients were recruited from four tertiary hospitals. Semi-structured face-to-face interviews were conducted between November 2016 and March 2017. The transcribed data were analyzed using qualitative content analysis to identify major themes and sub-themes that represented the experiences of critical care nurses. Results : The following six themes, and twelve sub-themes, were identified: (1) the gap between expectation and reality, (2) a distorted meaning of death, (3) repeated emotional pain and stress, (4) finding a solution alone, (5) sublimation into mission and calling, and (6) integration into one's own life. Conclusion : This study found that critical care nurses experience various psychological difficulties while caring for dying patients, and they made efforts on their own to overcome them. These findings are expected to inform the development of specialized programs to support critical care nurses to tackle these challenges, create guidelines on caring for dying patients, and help promote death education.