생애말 치료결정 과정에 대한 중환자실 간호사의 인식, 태도, 경험 : 국내 연구논문의 통합적 고찰

Abstract

Purpose : This integrative review aimed to synthesize studies on intensive care unit (ICU) nurses’ attitude, perceptions, and experiences toward end-of-life care decision-making. Methods : Using Whittermore and Knafl (2005)’s methods, we identified and synthesized research articles published in domestic journals between the years 2003 and 2019 and evaluated the quality of selected articles using the Mixed Methods Appraisal Tool. Results : In the 13 studies reviewed, 12 were published prior to enactment of the “The Act for Hospice and Palliative Care and Decision-Making about Life-Sustaining Treatment (2018).” All nine quantitative studies identified were based on cross-sectional descriptive survey. In four qualitative studies, content analysis (n=2) and phenomenology (n=2) were used. Overall, ICU nurses were well-aware of the necessity of communicating and limiting life-sustaining treatments. Many ICU nurses had positive attitude towards limiting life-sustaining treatments to promote patients’ comfort and dignity. Although nurses were willing to take active roles, they also reported having experienced high stress in the process of decision-making and implementation. Conclusions : It is important to prepare ICU nurses with proper knowledge and attitude regarding the topic area. It is also equally important to develop systems to support nurses’ emotional stress and moral distress during communication, decision-making, and implementation.