장기요양시설에서 치매 노인을 돌보는 간호사의 도덕적 고뇌에 대한 경험

Nurses Moral Distress on Caring for Older Adults with Dementia Residing in Long-Term Care Centers

Purpose: This study aimed to understand nurses experiences of moral distress when caring for elderly dementia patients who reside in long-term care centers. Methods: Colaizzi’s phenomenological approach was used for this study. The participants included eight nurses. Semi-structured in-depth interviews were used to collect data from February to August 2019. Results: Three categories emerged from the analysis. The nurses reported experiences of moral distress when caring for older adults with dementia. Theses experiences included “worrying about sincere care”, “a sense of guilt about task-oriented care”, “a feeling of helplessness because they cannot advocate care”. Seven theme clusters and 17 themes emerged in this study. The participants stated feeling conflicted about the meaning of care when they know secondary problemes will occur, but inevitably choose the next-best care option. The nurses could not provide proper care to their patients due to their overburdened workloads. The participants experienced a sense of guilt for caring only about the task at hand, without empathy. They felt helpless because that could not represent human rights and felt the gap between principle and reality as a nurse. Conclusion: These results suggest nurses’ moral distress must be considered to improve elderly dementia care. It is ethically and morally necessary for education programs to focus on caring for elderly dementia patients, and these findings can guide the program’s content and direction.