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관련 논문
*정책원 미소장 자료이며 관련 논문 소개 게시판입니다. 게시물 관련링크를 눌러 소속기관에서 열람가능한지 확인해주시기 바랍니다.
lib@nibp.kr
글 수 4,668
| 발행년 : | 2017 |
|---|---|
| 구분 : | 학위논문 |
| 학술지명 : | |
| 관련링크 : | http://www.riss.kr/link?id=T14374976 |
장기요양서비스를 제공하는 요양보호사의 임종케어 제공의향에 영향을 미치는 요인
= Predictors of End-of-Life Care Intention among Long Term Care Service Care Workers
- 저자
정현정
- 형태사항
v3, 72 p. ; 26 cm
- 일반주기
지도교수: 김현숙
- 학위논문사항
학위논문(석사)-- 한국교통대학교 글로벌융합대학원 : 노인복지학과 노년학 전공 2017. 2
- 발행국
충청북도
- 언어
한국어
- 출판년
2017
- 소장기관
- 한국교통대학교 중앙도서관
- 한국교통대학교 중앙도서관
- 초록 (Abstract)
- Abstract Predictors of End-of-Life Care Intention among Long Term Care Service Care Workers As the elderly population increases, personal and social interests in and demands on the mature end-of-life culture are increasing globally. While the elderly who spend their end-of-life in the long term care facilities have been the subject of popular research, the care workers who profoundly affect the quality of death for those in long term care service (LTC) have not been the proportional or rather insignificant subject in research. This study was to provide the basic data in order to prepare for the hospice palliative care policy and practical method for the LTC care workers clarifying the level and predictors of care worker's end-of-life care intention. This study was conducted with 206 care workers self-report in the structured questionnaire tailored to the research objective prepared through the literature review. The 206 subjects who enrolled in the elderly LTC facilities located in 'C' City 'C' Province and provided the care service were selected by nonprobability convenience sampling. The collected data was analyzed with the frequency, percentage, mean and standard deviation, ANOVA or t-test, Pearson's correlation analysis, and hierarchical multiple regression analysis using SPSS/WIN 22.0. The results are as follows. First, as for the socio-demographical characteristics of the 206 subjects, 50~59 years old took as 128 persons(62.1%) most by age distribution, the high school diploma took as 99 persons(48.1%) most by academic degree, 'exist' took 79.1% by existence of religion, and 'exist' took 83.5% by existence of spouse. As for the characteristics of general factors in the end-of-life care, 5 years or more of service career took 74 persons(35.9%) most, and 'not exist' took 53.4% by existence of participating end-of-life care training. The 'yes' took 86.4% by existence of recognition for the care worker's right of self determination, 'moderate intensity' took 45.6% most by cognitive degree of necessity for the end-of-life care, 'moderate intensity' took 36.9% most by cognitive degree of accountability for the end-of-life care, and 'no idea' took 53.4% by existence of cognition in the care worker's advance directives. The 'not exist' took 59.7% by existence of experiencing end-of-life care. Second, as a result of examining the level of major variables of the subjects, the grade point average of recognizing end-of-life care was average 3.0±0.28 out of full 4 scores, and the affective·philosophical domain among the subdomains corresponded to the highest value, and followed by necessity of promotion and education, contents of service, object, ethical and psychological domain in order. In addition, the perceived health status was 3.80±0.52 out of full 5 scores, and the physical health status among the subdomains corresponded to the highest value as 3.90±0.59, and followed by spiritual health status domain, mental health status domain, and social health status domain in order. The cognitive degree of necessity grade point average for the end-of-life care was 3.78±1.05 out of full 5 scores, and the cognitive degree of accountability grade point average for the end-of-life care was 3.46±1.11 out of full 5 scores. Third, as a result of analyzing the degree of socio-demographical factors, end-of-life care general factors, and degree of end-of-life care intention for the expertise factors of end-of-life care of the subjects, this study has found out that the existence of recognizing the right of self determination, end-of-life care cognitive degree of necessity, end-of-life care cognitive degree of accountability, and experience of end-of-life care showed statistically significant difference, and that the existence of religion had statistically significant trend. Fourth, as a result of analyzing the correlation among the recognition of end-of-life care, perceived health status, and end-of-life care intention, this study has shown that there was positive relationship in the recognition of end-of-life care, but there was no significant relationship in the perceived health status. However, the only physical health status among the subdomains of perceived health status showed the negative relationship. Fifth, as a result of conducting the hierarchical multiple regression analysis in order to investigate the factors which affected the end-of-life care intention, this study has shown that the recognition of end-of-life care, existence of experiencing end-of-life care, physical health status, end-of-life care cognitive degree of necessity, and end-of-life care cognitive degree of accountability had statistically significant effect. Based on these research findings, to improve the recognition of end-of-life care which affected the LTC care worker's end-of-life care intention, this researcher suggests that it needs to prepare for the systematic educational program related to the end-of-life care and include it in the compulsory continuous education. In addition, this researcher suggest that it needs to create an opportunity of motivation in order to become good quality of end-of-life care by presenting the careg worker's necessity of end-of-life care and cognition of responsibility for end-of-life care.
- 초록 (Abstract)
- 국 문 요 약 장기요양서비스를 제공하는 요양보호사의 임종케어 제공의향에 영향을 미치는 요인 고령인구의 증가와 함께 성숙한 임종문화에 대한 개인적, 사회적 관심과 요구가 전 세계적으로 증가하고 있다. 생의 마지막을 요양시설에서 보내게 되는 노인은 증가하고 있으나 이들의 죽음의질에 지대한 영향을 미치고 있는 요양보호사의 임종케어의향에 대한 연구는 미미한 수준이다. 이에 본 연구는 장기요양서비스를 제공하는 요양보호사의 임종케어 제공의향의 수준 및 그 영향요인을 밝혀 요양보호사를 위한 호스피스완화의료 정책 및 실천방안 마련에 기초자료를 제공하고자 실시되었다. 본 연구는 C도 C시에 소재하고 있는 노인요양시설에 등록되어 요양보호서비스를 제공하는 요양보호사들 중 비확률적 임의표집에 의해 편의 추출한 206명을 대상으로 연구자가 문헌고찰을 통해 연구목적에 적합한 구조화된 설문지에 연구대상자가 자가 보고하도록 하였다. 수집된 자료의 분석은 SPSS/WIN 22.0을 이용하여 빈도와 백분율, 평균 및 표준편차, ANOVA 또는 t검증, pearson상관관계분석, 위계적 다중회귀분석을 실시하였다. 본 연구의 결과는 다음과 같다. 첫째, 연구대상자 206명의 인구사회학적 특성은 연령분포가 50~59세인 경우가 128명(62.1%)으로 가장 많았고, 학력은 고졸인 경우가 99명(48.1%)으로 가장 많았으며, 종교유무는 ‘있다’가 79.1%를 차지하였고, 배우자 유무는 ‘있다’가 83.5%를 차지하였다. 임종케어의 일반적 요인의 특성은 근무경력이 5년 이상인 경우가 74명(35.9%)으로 가장 높게 나타났으며, 임종케어 훈련참가여부는 ‘없다’인 경우가 53.4%로 나타났다. 요양보호사의 자기 결정권에 대한 인정여부는 ‘예’가 86.4%를 차지하였고, 임종케어에 대한 필요성 인지정도는 ‘대체로 그렇다’인 경우가 45.6%로 가장 많았으며, 임종케어에 대한 책임성 인지정도 역시 ‘대체로 그렇다’ 인 경우가 36.9%로 가장 많았으며, 요양보호사의 사전연명의료의향서 인지여부는 ‘모른다’인 경우가 53.4%로 나타났다. 임종케어 경험유무는 ‘없다’인 경우가 59.7%를 차지하였다. 둘째, 연구대상자의 주요변수들의 수준을 살펴본 결과, 임종케어 인식의 평균평점은 4점 만점에 평균 3.0±0.28이었고, 세부영역 중에서는 정의‧철학 영역이 가장 높았고, 홍보 및 교육의 필요성, 서비스 내용, 대상자, 윤리 및 심리 영역 순으로 나타났다. 지각한 건강상태는 5점 만점에 3.80±0.52이었고, 세부영역 중에서는 신체적 건강상태가 3.90±0.59점으로 가장 높았고, 영적 건강상태, 정신적 건강상태, 사회적 건강상태 순으로 나타났다. 임종케어의 필요성 인지정도 평균평점은 5점 만점에 3.78±1.05점 이었고, 임종케어의 책임성 인지정도 평균평점은 5점 만점에 3.46±1.11 점으로 나타났다. 셋째, 연구대상자의 인구사회학적 요인 및 임종케어 일반적 요인, 임종케어 전문성 요인의 임종케어 제공의향 정도를 분석한 결과, 자기결정권 인정여부, 임종케어 필요성 인지정도, 임종케어 책임성 인지정도, 임종케어경험이 통계적으로 유의한 차이가 나타났으며, 종교유무는 통계적으로 유의한 경향이 있는 것으로 나타났다. 넷째, 임종케어인식, 지각한 건강상태와 임종케어제공의향간의 상관관계를 분석한 결과, 임종케어인식은 정적 상관관계가 나타났으며, 지각한 건강상태는 유의한 상관관계가 나타나지 않았다. 다만 지각한 건강상태의 세부영역 중 신체적 건강상태만이 부적 상관관계가 나타났다. 다섯째, 임종케어제공의향에 영향을 미치는 요인을 규명하기 위하여 위계적 다중 회귀분석을 실시한 결과, 임종케어인식, 임종케어경험유무, 신체적 건강상태, 임종케어 필요성 인지정도, 임종케어 책임성 인지정도가 통계적으로 유의한 영향을 미치는 것으로 나타났다. 본 연구결과에 근거하여 요양보호사의 임종케어제공의향에 영향을 미치는 것으로 나타난 임종케어 인식을 향상시키기 위해서는, 임종케어와 관련된 체계적인 교육 프로그램의 마련 및 의무 교육시수에 포함할 것을 제언한다. 또한 요양보호사의 임종케어 필요성과 임종케어 책임성 인지가 표출되어 질 좋은 임종케어가 될 수 있도록 동기부여의 기회를 만들어 줄 것을 제언한다.
- 목차 (Table of Contents)
- Ⅰ. 서론 ·············································1
- 1. 연구의 필요성 ·············································1
- 2. 연구의 목적 ················································3
- 3. 용어정의 ·····················································4
- Ⅱ. 이론적 배경 ···································6
- 1.요양보호사와 임종케어 ·································6
- 2.요양보호사의 임종케어제공의향에 영향을 미치는 요인들············································11
- 3. 연구모형 ······················································19
- Ⅲ. 연구방법․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․20
- 1. 연구설계 ·······················································20
- 2. 연구대상 ························································20
- 3. 자료수집 도구 ···············································20
- 4. 자료수집 방법 ···············································26
- 5. 자료분석 방법 ···············································26
- 6. 대상자의 윤리적 고려 ··································27
- Ⅳ. 연구결과 ․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․28
- 1. 연구대상자의 특성 ········································28
- 2. 연구대상자의 특성에 따른 임종케어제공의향의 차이 ··························································31
- 3. 연구대상자의 임종케어인식 수준 ··················34
- 4. 연구대상자의 임종케어인식, 지각한 건강
- 상태와 임종케어제공의향간의 상관관계······37
- 5. 임종케어제공의향 영향요인 ···························41
- Ⅴ. 논 의 ···························································45
- Ⅵ .결론 및 제언․ ······································51
- 1. 결론 ································································51
- 2. 제언·································································53
- 참고문헌 ······························································55
- Abstract ·······························································61
- 부록1. (생명윤리위원회 심의결과서)․․․․․․․․․․․․․․․․․․․․․․․․․65
- 부록2. (설문지)․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․66
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