The Life-sustaining Treatment Decisions Act has became enforced in 2018. Patients' decision-making on life-sustaining treatments can change according to their health status and situations and thus should be understood as the process requiring continuous care. Therefore, it is necessary to build a support system to help patients' decision-making at end-of-life care including life-sustaining treatments. Nurses provide continuous care at the bedside and play a significant role in supporting patients' and their families' decision-making about end-of-life care. Based on reviewing literature and the enforcing process of the Life-sustaining Treatment Decisions Act, this paper described nurses' nursing care activities to support decision-making on life-sustaining treatments. The nursing care activities are 'empathetic support for the decision-making,' 'respect for patients and families as agents for the decision-making,' and 'support for the decision-making as a counselor.' It can emphasize the importance of a nurse's role as a support system for patients’ and their families' decision-making about end-of-life care.
This study aimed to explore research trends of nursing ethics in Korea applying text network analysis and topic modelling. 306 articles published in KCI journals from 1998 to 2021 were identified and 516 author-provided keywords were collected. A co-occurrence matrix with 123 keywords, which appeared at least in two articles, were developed based on the Jaccard coefficient. Degree centrality and betweenness centrality were calculated and LDA topic modelling were performed using NetMiner software. The largest number of the articles (70, 23%) were published in Korean Journal of Medical Ethics. The most critical core-keywords, defined as the top 30 keywords in degree centrality and betweenness centrality, were ‘nursing students’ and ‘moral sensitivity’. The other core-keywords included ‘attitude,’ ‘awareness,’ ‘professionalism,’ ‘knowledge,’ and ‘critical thinking.’ related to ethical competence, ‘death,’ ‘hospice,’ ‘euthanasia,’ and ‘research ethics’ related to bioethical issues, and ‘job satisfaction,’ ‘burn out,’ ‘stress,’ ‘organizational culture,’ ‘ethical leadership,’ and ‘ethical climate’ related to organization and leadership. Five topics were identified and named as a) bioethics education for nursing students, b) knowledge and attitudes for bioethical issues, c) awareness and values of bioethics, d) ethical conflicts of RNs, and e) nursing ethics education. This study found that bioethics was the main topics in Korean nursing ethics research and suggested nursing research should focus on ethical issues RNs frequently experience in patient care. Also, research gaps were inferred in multiple topics including nurse-to-nurse relationships, theoretical perspectives of virtue ethics and care ethics, or witnessing healthcare professionals’ unethical behavior.
This study is a descriptive correlation study to explore the intention of nursing for patients with COVID-19 among nurses in a tertiary hospital in Seoul, and to identify factors influencing the nursing intention. Data were collected from 239 nurses with more than 6 months of working experience from December 1, 2020 to December 31, 2020. Data were analyzed by t-test, ANOVA, Scheffé test, Pearson's correlation coefficient, and Hierarchical multiple regression using the SPSS WIN 24.0 program. According to a result of this study, the score of participant's nursing intention for patients with COVID-19 was an average of 4.48 points out of 7 points. Factors influencing the nursing intention were control beliefs, position, positive behavior beliefs, negative behavior beliefs, and normative beliefs: Among the factors influencing nursing intentions, control beliefs have been shown to have the greatest influence. These variables accounted for 65.2% of the variance in the nursing intention. Therefore, to increase the nursing intention for patients with COVID-19, it is necessary to educate and train nurses to strengthen their confidence in caring the patients. In addition, repeated studies were suggested with extended sample in other settings and to find other factors influencing the nursing intention.
Nurses in an intensive care unit (ICU) often play key roles to improve the quality of end-of-life care. During those times, many nurses report they feel ambivalent in the caring between life and death. The purpose of this study was to analyze the concept of ambivalence that ICU nurses often experienced in end-of-life care. As a method, this study was conducted with the concept analysis using the hybrid model Schwartz-Barcott and Kim (1986) presented, naming the complex and dual feelings nurses experience during end-of-life care in ICU as ambivalence. In the theoretical phase and from the literature review, characteristics of ambivalence were identified. During the fieldwork phase, in-depth interviews were conducted with five nurses. In the final phases, a theoretical description was extracted of ambivalence in ICU nurses during end-of-life care. In terms of results, external factors (i.e., realistic context, contradictions in nursing activities themselves) and internal factors (i.e., personal tendencies, conflicting perceptions of dying, occupational awareness of nurses, role conflicts) were derived as antecedents of ICU nurses’ ambivalence during end-of-life care. Attributes were divided into intrinsic and existential dimensions. Intrinsic dimensions resulted in "coexistence of opposing equivalent values," "uncertainty," "hiddenization," "value confrontation may occur sequentially," and "absence of willingness to resolve." In existential dimensions, the following conflicts were derived: "pressure on work versus sympathy about family grief," "helplessness due to failure of medical care versus sadness for patient death" and "role as a nurse versus sadness felt during end-of-life care.” The results are organized into negative assessments of oneself and adaptations to ambivalence. In conclusion, through this concept analysis, the hope is that ICU nurses will be able to prevent progressing to burnout by accurately and actively facing and managing their own feelings during end-of-life care. Furthermore, this research is expected to serve as the cornerstone of developing theories for clinicians who provide end-of-life care.
Purpose: The purpose of this study was to clarify the definition of ‘death attitude’ reflecting the passage of time and socio-cultural context through conceptual analysis . Method: The concept of ‘death attitude’ was analyzed using a hybrid model to clarify the concept's properties and definition. For theoretical analysis, literature published from 2016 to 2021 was searched and a total of 33 articles including 25 domestic and 8 foreign studies were analysed. For a field study, seven adults were interviewed in May-June, 2021. Result: The domain of ‘death attitude’ concept were deduced into positive, neutral, and negative domains. At the field research stage, 'how to relieve the burden on those left behind' under the 'escape' attribute, 'no time to think about death' under the 'avoidance' attribute, and 'anxiety about unexpected death' under the 'anxiety' attribute were newly discovered. Conclusions: ‘Death attitude’ is a positive, neutral, or negative attitude toward death according to multuple characteristics such as demographics, spiritual well-being, direct or indirect experiences of death, or death-related educational experiences. Death attitude affects quality of life, meaning of life, and end-of-life care. It is important for nurses to be aware of their own death attitudes in order to provide quality end-of-life care to patients and their families.