DOI QR코드

DOI QR Code

The Mediating Effect of Biomedical Ethics Awareness in the Relationship between the Moral Distress and Moral Sensitivity of Hospital Nurses

병원 간호사의 도덕적 민감성과 도덕적 고뇌와의 관계에서 생명의료윤리의식의 매개효과

  • 김옥현 (청암대학교 간호학과) ;
  • 안성아 (진주보건대학교 간호학부) ;
  • 오수미 (한국국제대학교 간호학과) ;
  • 공정현 (진주보건대학교 간호학부) ;
  • 최혜옥 (진주보건대학교 간호학부)
  • Received : 2019.07.10
  • Accepted : 2019.09.20
  • Published : 2019.09.27

Abstract

In the study, the moral sensitivity, moral distress, and biomedical ethics awareness levels of hospital nurses are examined, and the mediating effect of biomedical ethics awareness in the relationship between moral sensitivity and moral distress is verified. As the study subjects, 153 hospital nurses were selected from both university hospitals and general hospitals in S city and J city. Using the SPSS WIN 21.0 system, data analysis was conducted via t-tests, the Sheffe test, correlation analysis, multiple regression analyses, Sobel test. The average level of moral sensitivity experienced by the hospital nurses was 4.70(out of 7), moral distress was 62.80(out of 336), and biomedical ethics awareness was 2.21(out of 4). Moral distress had a static correlation with moral sensitivity and biochemical ethics awareness, and moral sensitivity had a static correlation with biomedical ethics awareness. Finally, biomedical ethics awareness showed a partial mediating effect in the relationship between moral sensitivity and moral distress. It is important to develop a biomedical ethics education program that can help hospital nurses to resolve moral issues, thereby improving moral sensitivity and diminishing their moral distress.

본 연구는 병원 간호사를 대상으로 병원 간호사가 경험하는 도덕적 민감성이 도덕적 고뇌에 미치는 영향을 파악하고, 도덕적 민감성과 도덕적 고뇌의 영향관계에서 생명의료윤리의식의 매개효과를 검증하는 것이다. 연구대상자는 S시, J시에 소재하고 있는 종합병원에 근무하고 있는 병원 간호사 153명을 선정하였다. 자료분석은 SPSS WIN 21.0을 이용하여 t-test, ANOVA, Scheffe test, 상관관계분석, 단순 및 다중회귀분석과 Sobel test을 하였다. 병원 간호사가 경험하는 도덕적 민감성은 평균 4.70점(7점 만점), 도덕적 고뇌는 62.80점(336점 만점), 생명의료윤리의식은 2.21점(4점 만점)이었고, 도덕적 고뇌는 도덕적 민감성과 생명의료 윤리의식과 정적 상관관계, 도덕적 민감성과 생명의료윤리의식 간에 정적상관관계가 있었다. 마지막으로 생명의료윤리의식이 도덕적 민감성과 도덕적 고뇌의 관계를 부분 매개효과가 있는 것으로 나타났다. 병원 간호사의 도덕적 민감성 향상 및 도덕적 고뇌 감소를 위해 도덕적 문제를 해결할 수 있도록 능력을 향상시키는 생명의료윤리교육 프로그램 개발이 무엇보다 중요하다.

Keywords

References

  1. Y. Hayne, S. Moore & M. Osborne. (1990). A turning point. Nursing Forum, 25(4), 10-30. DOI : 10.1111/j.1744-6198.1990.tb00859.x
  2. S. J. Han. (2012). Relationship between moral distress and turnover intention among hospital nurses. The Journal of the Korea Contents Association. 12(3), 276-284. DOI : 10.5392/JKCA.2012.12.03.276
  3. M. C. Corley. (2002). Nurse moral distress: A proposed theory and research agenda. Nursing Ethics, 9(6), 636-659. DOI : 10.1191/0969733002ne557oa
  4. M. S. Yoo. (2004). Concept analysis of moral distress in nurses. Journal of Korean Academy of Nursing Administration, 10(1), 49-62.
  5. S. S. Han. (2005). The moral distress experienced by hospital nurses. The Korean Bioethics Association, 6(2), 31-47.
  6. E. H. Elpern, B. Covert & R. Kleinpell. (2005). Moral distress of staff nurses in a medical intensive care unit. American Journal of Critical Care, 14(6), 523-530. https://doi.org/10.4037/ajcc2005.14.6.523
  7. J. R. Rest. (1986). Moral development: Advances in research and theory. NY : praeger.
  8. M. S. Kim. (2015). Influence of moral sensitivity and ethical values on biomedical ethics awareness of nursing students. The Journal of Korean Academic Society Nursing Education, 21(3), 382-392. DOI : 10.5977/jkasne.2015.21.3.382
  9. J. A. Kim & Y. S. Kang. (2018). Moral distress and moral sensitivity of nurses working in long term care hospitals. Journal of Korean Academia-Industrial cooperation society, 19(6), 240-251. DOI : 10.5762/KAIS.2018.19.6.240
  10. M. O. Kim. (2015). Awareness of biomedical ethics of long-term care hospital nurses. Journal of the Korea Academia-Industrial cooperation Society, 16(6), 4048-4055. DOI : 10.5762/KAIS.2015.16.6.4048
  11. J. Y. Ha, D. H. Kim & S. K. Hwang. (2009). The perception of biomedical ethics in nurses. The Journal of Korean Academic Society of Nursing Education, 15(2), 2016-2224. DOI : 10.5977/JKASNE.2009.15.2.216
  12. D. B. Noh, S. A. Kim & S. H. Kim. (2013). Moral distress, moral sensitivity and ethical climate of nurses working in psychiatric wards. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 22(4), 307-319. DOI : 10.12934/jkpmhn.2013.22.4.307
  13. S. S. Han, J. H. Kim, Y. S. Kim & S. H. Ahn. (2010). Validation of korean version of moral sensitivity questionnaire. Nursing ethics, 17(1), 99-105. DOI : 10.1177/0969733009349993
  14. K. Lutzen, M. Evertzon & C. Nordin. (1997). Moral sensitivity in psychiatric practice, Nursing Ethics, 4(6), 472-480. DOI : 10.1177/096973309700400604
  15. A. B. Hamric, C. T. Borchers & E. G. Epstein. (2012). Development and testing of an instrument to measure moral distress in healthcare professionals. Acta Biomaterialia Odontologica Scandinavia Primary Research, 3(2), 1-9. DOI : 10.1080/21507716.2011.652337
  16. Y. R. Chae, S. J. Yu, E. J. Lee, K. J. Kang, M. S. Park & M. Yu. (2016). Validity and reliability of the korean version of the moral distress scale-revised for korean hospital nurses. The Journal of Korean Academic Society of Nursing Education, 22(2), 228-239. https://doi.org/10.5977/jkasne.2016.22.2.228
  17. S. J. Kwon. (2003). A Study on the consciousness of biomedical ethics of the Nursing students and medical students. Master'sdissertation. Keimyung University. Daegu.
  18. H. R. Kim & S. H. Ahn. (2010). Moral sensitivity and moral distress among korean hospital nurses. The Korean Society for Medical Ethics. 13(4), 321-336. DOI : 10.5977/jkasne.2016.22.2.228
  19. M. A. Lee, S. H. Ahn, Y. S. Kang, G. A. Seomun & M. J. Shin. (2006). An evaluation of the Level of moral development of clinical nurses in Korea. The Korean Society for Medical Ethics, 9(1), 73-84.
  20. S. S. Han, Y. S. Kim, J. H. Park, S. H. Ahn & K. H. Meng. (2007). A study of the moral sensitivity of nurses and nursing students in Korea. The Korean Society for Medical Ethics, 10(2), 117-124. https://doi.org/10.35301/ksme.2007.10.2.117
  21. M. S. Lee. (2011). An exploratory study on moral sensitivity measurement of Korean youths. Korean Journal of Youth Studies, 18(8), 1-20.
  22. B. H. Park & Y. J. Oh. (2017). Impact of ethical climate and ethical leadership perceived by nurses on moral distress. Journal of the Korean Data Analysis Society, 19(2), 1099-1116. https://doi.org/10.37727/jkdas.2017.19.2.1099
  23. L. B. Tiedje. (2000). Moral distress in perinatal nursing. Journal of Perinatal and Neonatal Nursing, 14(2), 36-43. DOI : 10.1097/00005237-200009000-00005
  24. C. M. Beumer. (2008). Innovative solutions: the effect of a workshop on reducing the experience of moral distress in an intensive care unit setting. Dimensions of Critical Care Nursing, 27(6), 263-267. DOI : 10.1097/01.DCC.0000338871.77658.03
  25. D. Brandon, D. Ryan, R. Sloane & S. L. Docherty. (2004). Impact of a pediatric quality of life program on providers' moral distress. MCN, The American Journal of Maternal/Child Nursing, 39(3), 189-197. DOI : 10.1097/NMC.0000000000000025
  26. M. Y. Moon, M. K. Jeon & A. H. Jaung. (2013). Relationship between nurses' consciousness of biomedical ethics, job satisfaction and nursing performance. Journal of the Korean Medical Association, 14(1), 24-47.
  27. H. Y. Hwang. (2017). The current status and consideration for nursing ethics education in south korea. Korean Journal of Medical Ethics, 20(3), 305-316. https://doi.org/10.35301/ksme.2017.20.3.305
  28. S. H. Kim & N. H. Lee. (2017). The influence of sensitivity of emergency medical technology students on biomedical ethics. Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology, 7(3), 757-764. DOI : 10.14257/AJMAHS.2017.03.18
  29. E. A. Kim, H. Y. Park & S. E. Choi. (2014). The influence of moral sensitivity and critical thinking dispositions on biomedical ethics awareness of nursing students. The Korean Society for Medical Ethics, 17(2), 144-158. https://doi.org/10.35301/ksme.2014.17.2.144
  30. M. C. Corley, R. K. Elswick, M. Gorman M & T. Clor. (2001). Development and evaluation of a moral distress scale. Journal of Advanced Nursing, 33, 250-256. DOI : 10.1111/j.1365-2648.2001.01658.x
  31. J. Y. Baek, E. A. Lee & C. R. Jeong. (2016). Exploration of the biomedical ethics education module used in the UNESCO bioethics core curriculum. The Korean Society for Medical Ethics, 19(3), 282-296. https://doi.org/10.35301/ksme.2016.19.3.282