호스피스병동과 내과병동 간호사의 암성통증관리에 대한 지식과 수행도

Abstract

본 연구는 보건복지가족부의 암성 통증관리치침 권고안(2010)을 중심으로 암환자의 통증 조절을 전문적으로 하는 호스피스병동과 일반 병동 중에서 암환자들이 많이 입원하는 내과병동 간호사의 암성통증관리에 대한 지식 및 수행도를 파악하기 위한 서술적 비교 연구이다. 연구 대상은 호스피스병동 간호사는 호스피스병동이 있는 경기도 2곳과 대전, 전북의 각각 1곳, 서울시 1곳과 제주도 1곳의 50명, 내과병동 간호사는 경기도 1곳의 53명를 대상으로 하였다 자료수집은 간호부의 동의를 받은 후 2010년 10월 18일부터 2010년 11월 6일까지 실시하였다. 연구 도구는 조은경(2009)이 개발한 지식 및 수행실태의 측정도구를 수정 보완하여 사용하였고, 일반적 특성 11문항, 지식24문항, 수행 정도 19문항, 총 54문항으로 구성되어 있다. 수집된 자료는 SPSS 17.0 프로그램을 이용하여 빈도, 백분율, 평균, 표준편차, χ²-test, Fisher's exact test, t-test, Pearson's correlation으로 분석하였다. 연구 결과를 요약하면 다음과 같다. 1. 호스피스병동 간호사와 내과병동 간호사의 일반적 특성을 비교한 결과 종교를 제외한 연령, 학력, 결혼상태, 직위, 총 근무년수, 현부서 근무년수, 암환자 간호경력, 통증관리 교육 이수, 통증관리 지침 권고안 인지여부에 있어서 통계적으로 유의한 차이를 나타내었다. 호스피스병동 간호사는 내과병동 간호사보다 연령이 많고, 학력이 고학력이며, 임상 경험이 오래되고, 풍부하였다. 또한 통증관리 교육 이수와 암성 통증관리 치침 권고안을 인지하는 호스피스병동 간호사가 암성 통증관리에 대한 지식과 수행도가 더 높고, 적극적이었음을 보여주였다. 2. 암성 통증 관리에 대한 총 지식 정도는 전체 100점을 만점으로 볼 때 호스피스 병동 간호사의 평균이 83.0± 9.0로 내과 병동 간호사의 평균 65.2± 9.60 보다 통계적으로 유의하게 높았다(t=-9.542, p=.000). 3. 암성 통증관리에 대한 수행정도는 4점 만점으로 볼 때 총 평균 평점은 호스피스병동 간호사는 3.55± 0.38로 내과병동 간호사 3.28± 0.30 보다 유의하게 높아서(t=-3.967, p=.000), 호스피스병동 간호사가 내과병동 간호사보다 적극적으로 통증관리 수행을 하고 있음을 보였다. 4. 암성 통증관리에 대한 지식과 수행도 간의 관계에서는 호스피스병동 간호사는 지식과 수행도 간에 정적 상관관계로 지식이 높을수록 수행도가 높다고 나타났고, 통계적으로도 유의하였다(r=.293, p=.039). 내과병동 간호사는 지식과 수행도 간에 정적 상관관계가 있었으나 유의하지 않은 것으로 나타났다.

결론적으로 호스피스병동과 내과병동 간호사는 종교를 제외한 일반적인 특성에서 모두 유의한 차이를 나타났기 때문에 호스피스병동 간호사가 내과병동 간호사보다 암성 통증관리 지식과 수행에 높은 점수를 보였다. 따라서 암환자들이 많이 입원하고 있는 내과병동 간호사에게도 보다 체계적이고 효과적인 통증관리를 하기 위해서는 암성 통증관리지침에 기반한 계속적인 교육이 필요하며 보건복지가족부의 암성 통증 관리지침 권고안(2010)을 홍보하여 내과병동 간호사가 이를 숙지하도록 하는 방안이 마련되어야 할 것이다.

|This descriptive and comparative study intends to understand knowledge and performance of cancer pain management of nurses working in medical wards where a lot of cancer patients go into, of hospice ward and general ward to professionally control pain of cancer patients, based on Cancer Pain Management Guideline announced in 2010 by the Ministry for Health, Welfare and Family Affairs. For achieving this objective, this study was conducted targeting 50 nurses working in 2 hospice wards, Kyung-gi province, 1 hospice ward, Dae-jeon, 1 hospice ward, Cheon-buk, 1 hospice ward, Seoul and 1 hospice ward, Je-ju island, and 53 nurses working in 1 medical ward, Kyung-gi province. After getting their concent, questionnaires were distributed to them and data were collected from Oct. 18th to Dec. 6th, 2010. To analyze collected data, measuring tool of knowledge and performance developed by Jo, Eun-kyung(2009) was modified and complemented. Questionnaire was organized with total 54 questions(11 questions of general characteristics, 24 questions of knowledge, 19 questions of performance). Collected data was analyzed using SPSS 17.0 program, according to frequency, percentage, average, average deviation, χ²-test, Fisher's exact test, t-test and Pearson's correlation. Research results derived are as follows; Firstly, when comparing general characteristics of nurses in hospice units to nurses' in medical wards, there were statically significant differences in age, educational background, marriage, position, total employment period, employment period in the current department, career of cancer patient care, pain management training completed and understanding of Cancer Pain Management Guideline, except for religion. In general, nurses in hospice wards were older than those in medical wards, they had higher educational background and older and richer medical experience. Also, nurses in hospice wards who completed a pain management training and understood Cancer Pain Management Guideline, had more knowledge and better performance of that, and were more positive to work than nurses in medical wards. Secondly, when surveying total knowledge of cancer pain management of nurses, there was a significant difference between nurses in hospice wards and medical wards(t=-9.542, p=.000). That is, nurses in hospice wards had higher average points at 83.0± 9.0 out of 100 than nurses in medical wards who had 65.2± 9.60 of average. Thirdly, when measuring performance of cancer pain management of nurses, nurses in hospice wards had higher average points at 3.55± 0.38 out of 4 than nurses in medical wards who had 3.28± 0.30 of points(t=-3.967, p=.000). It implies that nurses in hospice wards are more aggressive to take care of pain what cancer patients have, than nurses in medical wards. Fourthly, there was a statistically positive correlation between knowledge and performance of cancer pain management nurses of hospice units. That is, they had more knowledge, as they showed better performance(r=.293, p=.039). There was a positive correlation TOO between knowledge and performance of nurses in medical wards, but it was not that significant.

In conclusion, there were significant differences in every general characteristic, except for religion between nurses in hospice wards and medical wards, and nurses of hospice wards had more knowledge and better performance of cancer pain management than nurses of medical wards. These findings mean that we need to implement a professional cancer pain management training constantly for nurses in medical wards where a lot of cancer patients enter to manage pain more systematically and effectively, based on Cancer Pain Management Guideline, and plan some measures to publicize Cancer Pain Management Guideline(2010) announced by the Ministry for Health, Welfare and Family Affairs and to help nurses of medical wards well-informed of that.; This descriptive and comparative study intends to understand knowledge and performance of cancer pain management of nurses working in medical wards where a lot of cancer patients go into, of hospice ward and general ward to professionally control pain of cancer patients, based on Cancer Pain Management Guideline announced in 2010 by the Ministry for Health, Welfare and Family Affairs. For achieving this objective, this study was conducted targeting 50 nurses working in 2 hospice wards, Kyung-gi province, 1 hospice ward, Dae-jeon, 1 hospice ward, Cheon-buk, 1 hospice ward, Seoul and 1 hospice ward, Je-ju island, and 53 nurses working in 1 medical ward, Kyung-gi province. After getting their concent, questionnaires were distributed to them and data were collected from Oct. 18th to Dec. 6th, 2010. To analyze collected data, measuring tool of knowledge and performance developed by Jo, Eun-kyung(2009) was modified and complemented. Questionnaire was organized with total 54 questions(11 questions of general characteristics, 24 questions of knowledge, 19 questions of performance). Collected data was analyzed using SPSS 17.0 program, according to frequency, percentage, average, average deviation, χ²-test, Fisher's exact test, t-test and Pearson's correlation. Research results derived are as follows