Korean J Adult Nurs.  2017 Apr;29(2):131-142. 10.7475/kjan.2017.29.2.131.

Attitude, Role Perception and Nursing Stress on Life Sustaining Treatment among Intensive Care Unit Nurses

• Lee SJ
• Kim HY

• KMID: 2378867
• DOI: http://doi.org/10.7475/kjan.2017.29.2.131

Abstract

PURPOSE
The aims of the study were to investigate relationships among intensive care unit (ICU) nurses' attitude, role perception, and nursing stress related to life sustaining treatment (LST), and secondly, to identify factors influencing nursing stress about LST.
METHODS
Participants were 202 conveniently sampled ICU nurses from general hospitals in Korea with over 300 beds. From December 1, 2015 to January 31, 2016, data were collected using structured questionnaires. The questionnaire was designed to measure nursing stress related to LST. Content validity and reliability was established for the instrument.
RESULTS
Relationships were found between attitude and role perception, and between role perception and nursing stress about LST. Participants' role perception, gender, education level, and the experience of dealing with family members of patients receiving LST accounted for 13% of variance in nursing stress about LST.
CONCLUSION
Results confirmed that ICU nurses' role perception affects nursing stress about LST. Accordingly, the nursing education programs related to LST should aim to enhance role perception of nurses, and strategies to reduce the nursing stress about LST of the nurses in ICU need to be further developed.

MeSH Terms

Critical Care*
Education
Education, Nursing
Hospitals, General
Humans
Intensive Care Units*
Korea
Life Support Care
Nursing*
Reproducibility of Results

Reference

1. Ministry of Health and Welfare. Provided the legal basis for hospice care, palliative care and withdrawing of life-sustaining treatment [Internet]. Seoul: Ministry of Health and Welfare;2016. [cited 2016 February 7]. Available from:. http://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=329848.

2. Monteiro F. Family reliance on physicians' decisions in life- sustaining treatments in acute-on-chronic respiratory diseases in a respiratory ICU: a single-center study. Respiratory Care. 2014; 59(3):411–9. https://doi.org/10.4187/respcare.02695.

3. Vanderspank-Wright B, Fothergill-Bourbonnais F, Brajtman S, Gagnon P. Caring for patients and families at end of life: The experiences of nurses during withdrawal of life-sustaining treatment. Dynamics. 2011; 22(4):31–5.

4. Jox RJ, Krebs M, Fegg M, Reiter-Theil S, Frey L, Eisenmenger W, et al. Limiting life-sustaining treatment in German intensive care units: a multiprofessional survey. Journal of Critical Care. 2010; 25(3):413–9. https://doi.org/10.1016/j.jcrc.2009.06.012.

5. Bae JM, Gong JY, Lee JR, Heo DS, Koh YS. A survey of patients who were admitted for life-sustaining therapy in nationwide medical institutions. The Korean Journal of Critical Care Medicine. 2010; 25(1):16–20. https://doi.org/10.4266/kjccm.2010.25.1.16.

6. Heo KS. A Study on the relationships between job characteristics and organizational commitment of hospital organization. Journal of Human Resource Management Research. 2005; 12(1):21–45.

7. Golubic R, Milosevic M, Knezevic B, Mustajbegovic J. Work related stress, education and work ability among hospital nurses. Journal of Advanced Nursing. 2009; 65(10):2056–66.

8. Hoffman AJ, Scott LD. Role stress and career satisfaction among registered nurses by work shift patterns. Journal of Nursing Administration. 2003; 33(6):337–42.

9. Lee SJ, Kim HY. Experience of life-sustaining treatment in patient care among intensive care unit nurses: phenomenological approach. Journal of Korean Academy of Fundamentals of Nursing. 2016; 23(2):172–83. https://doi.org/10.7739/jkafn.2016.23.2.172.

10. Park HS, Kim KN. Factors affecting burnout in ICU nurses. Journal of Korean Academy of Fundamentals of Nursing. 2010; 17(3):409–18.

11. Lim DS, Cho BH. The Study on stress, hardiness, and professional burnout of intensive care unit nurses. Journal of the Korean Academy of Fundamentals of Nursing. 2007; 14(1):120–7.

12. Cho YA, Kim GS, Kim ES, Park HM, Yoo M, Lim EO, et al. A correlational study on ICU nurses' job stress, the way of coping, and the turnover intention. Journal of Korean Clinical Nursing Research. 2009; 15(3):129–41.

13. Yaguchi A, Truog RD, Curtis JR, Luce JM, Levy MM, Mélot C, et al. International differences in end-of-life attitudes in the intensive care unit: Results of a survey. Archives of Internal Medicine. 2005; 165(17):1970–5. https://doi.org/10.1001/archinte.165.17.1970.

14. Kim MS. Social perception of euthanasia [Internet]. Sejong: Korea Institute for Health and Social Affairs;2002. [cited 2015 November 16]. Available from:. https://www.kihasa.re.kr/web/publication/pdsdebate/view.do?menuId=47&tid=57&bid=-1&ano=176.

15. Yeun EJ, Lee MY, Song MS. Attitudes toward life sustaining treatment (LST) among Korean adults: An application of Q- methodology. Journal of Korean Society for the Scientific Study of Subjectivity. 2011; 22:129–45.

16. Scherer Y, Jezewski MA, Graves B, Wu YWB, Bu X. Advance directives and end-of-life decision making survey of critical care nurses' knowledge, attitude, and experience. Critical Care Nurse. 2006; 26(4):30–40.

17. Park MO, Yun HJ. Nurse's experience dealing with ethical dilemma in intensive care unit. Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology. 2016; 6(8):81–93. https://doi.org/10.14257/AJMAHS.2016.08.36.

18. Park YO, Chang BH, Yoo MS, Cho YS, Kim HS. Nurses' perception over withdrawal of life-sustaining treatment. Korean Journal of Medical Ethics Education. 2004; 7(2):198–216.

19. Adams JA, Bailey Jr. DE, Anderson RA, Docherty SL. Nursing roles and strategies in end-of-life decision making in acute care: a systematic review of the literature. Nursing Research and Practice. 2011; 2011:1–15. https://doi.org/10.1155/2011/527834.

20. Silén M, Svantesson M, Ahlström G. Nurses' conceptions of decision making concerning life-sustaining treatment. Nursing Ethics. 2008; 15(2):160–73.

21. Lee SH, Kim JS, Hwang MJ, Hwang BD, Park YJ. Ethical dilemma associated with DNR: The Attitude of clinical nurse. Clinical Nursing Research. 1998; 4(1):147–62.

22. Byun EK, Choi HR, Choi AL, Hong KH, Kim NM, Kim HS. An investigative research on the attitudes of intensive care unit nurses and families on terminating life support. Clinical Nursing Research. 2003; 9(1):112–24.

23. Lee HK, Kang HS. Attitudes and awareness towards the withdrawal of life-sustaining treatment among nurses, physicians, and families of intensive care unit patients. Journal of Korean Clinical Nursing Research. 2010; 16(3):85–98.

24. Kwon YO, Ahn SH. The Attitude and perception on withdrawal of futile life sustaining treatment and patient self determination right among home care nurses. Journal of the Korean Bio-ethics Association. 2013; 14(2):53–66.

25. Park GS. The study of consciousness of euthanasia among health professionals: Q-methodological approach [master's thesis]. Seoul: Dankook University;2000.

26. Kim AK, Park GS. The study of meaning in euthanasia and hospice nursing among nurses. The Journal of Fundamentals of Nursing. 2000; 7(3):379–90.

27. Yi MS, Oh SE, Choi EO, Kwon IG, Kwon SB, Cho KM, et al. Hospital nurses' experience of Do-Not-Resuscitate in Korea. Journal of Korean Academy of Nursing. 2008; 38(2):298–309. https://doi.org/10.4040/jkan.2008.38.2.298.

28. Ha MO. Nurses' awareness and attitudes concerning the termi-nation of life sustaining medical care [master's thesis]. Seoul: Kyung Hee University;2010.

29. Kim SJ. Experienced stress and adaptation of intensive care unit nurse [master's thesis]. Gwangju: Chosun University;200.

30. Han SS, Kim OS, Joo YS, Choi ED, Han JW. Effects of nurses' mentoring on turnover intention: Focused on the mediating effects role stress and burnout. Journal of Korean Academy of Nursing. 2013; 43(5):605–12. https://doi.org/10.4040/jkan.2013.43.5.605.