İntörn Hemşirelerin Kanser Hastalarına Bakım Verirken Ölüm Kavramına İlişkin Yaşadığı Deneyimler ve Tutumları: Tanımlayıcı ve Kesitsel Bir Çalışma

Yıl 2023, , 711 - 718, 31.12.2023

Tangül Aytur Özen , Cigdem Erdem

https://doi.org/10.54005/geneltip.1287997

Öz

Amaç: Bu çalışma, intörn hemşirelik öğrencilerinin kanserli bireylere bakım verirken ölüm kavramına ilişkin tutum ve deneyimlerini belirlemek amacıyla tanımlayıcı ve kesitsel olarak olarak yapılmıştır.
Yöntemler: Araştırmanın örneklemini, 94 intörn hemşire öğrenci oluşturmaktadır. Veriler, Sosyodemografik özellikler ile ölüm kavramına ilişkin veri formu ve Frommelt Ölüm Sürecinde Ölüme İlişkim Tutum Ölçeği ile yüz yüze görüşme yöntemi ile toplanmıştır. Verilerin analizinde; tanımlayıcı istatistikler, Mann Whitney U ve Kruskal-Wallis testleri kullanılmıştır.
Bulgular: Öğrencilerin % 91.5’i klinik dışı, % 70.2’si klinik ortamda ölüm olgusu ile karşılaşmış ve % 58.5’i beş ve daha fazla ölmek üzere olan hastaya bakım vermiştir. Öğrencilerin % 67.1’i görüşme ve veri toplama aşamasında, % 22.3’ü tüm hemşirelik süreçlerinde güçlükler yaşamıştır. % 47.3’ü çaresizlik ve % 19.7’si keder hissi deneyimlemiştir. Mevcut çalışmada ortalama FATCOD puanı 73.00 ± 8.70 olarak bulunmuştur. Öğrencilerin kanser hastası ile ölüm kavramı konusunda konuşurken kendilerini rahat hissetme durumu açısından ölçek puanı açısından fark bulunmuştur (p<0.05).
Sonuç: İntörn hemşirelik öğrencilerinin çaresizlik duyguları yaşadıkları saptanmıştır. Öğrenciler; hem teorik hem de klinik uygulamada hemşirelik sürecinin tüm aşamalarına odaklanan stratejilere ihtiyaç duymaktadırlar.

Anahtar Kelimeler

Hemşirelik, intörn hemşireler, kanser hastası, ölüme ilişkin tutum.

Intern Nurses’ Experiences and Attitudes Towards the Concept of Death While Providing Care for Cancer Patients: A Descriptive and Cross-Sectional Study

Öz

Aim: This study was conducted using a descriptive and cross-sectional method to determine the attitudes and experiences of intern nursing students toward the concept of death while providing care for individuals with cancer.
Methods: The sample of the study consists of 94 intern nurse students. The data were collected through face-to-face interviews using the data form including questions about sociodemographic characteristics and the concept of death, and the Frommelt Attitude Towards Care of the Dying Instrument. Descriptive statistics, Mann Whitney U and Kruskal-Wallis tests were used in the analysis of the data.
Results: Of the students 91.5% encountered the concept of death outside the clinical environment, while 70.2% encountered in the clinical setting, and 58.5% provided care for five or more dying patients. Of the students 67.1% had difficulties in the interviewing and data collection process, and 22.3% had difficulties in all nursing practices. 47.3% said they experienced helplessness, and 19.7% said they experienced grief. In the current study, it was found that the mean FATCOD score was 73.00 ± 8.70. There was a difference in the scale scores in terms of the students' status of feeling comfortable talking to a cancer patient about the concept of death (p<0.05).
Conclusions: Intern nursing students have experienced helplessness. Students need strategies focusing on all stages of the nursing process in both theoretical and clinical practice.

Anahtar Kelimeler

attitude toward death, individual with cancer, intern nurses, nursing

Teşekkür

We would like to thank all the intern nurses of valuable contributions to this study.

Kaynakça

• WHO. Cancer 2020 [Available from: https://www.who.int/news-room/fact-sheets/detail/cancer.
• Nissen KG, Trevino K, Lange T, Prigerson HG. Family Relationships and Psychosocial Dysfunction Among Family Caregivers of Patients With Advanced Cancer. J Pain Symptom Manage. 2016;52(6):841-9.e1.
• Hashemi M, Irajpour A, Taleghani F. Caregivers needing care: the unmet needs of the family caregivers of end-of-life cancer patients. Support Care Cancer. 2018;26(3):759-66.
• Filiz NY, Dikmen Y. Yaşam sonu bakım uygulamalarında hasta savunuculuğu. Journal of Human Rhythm. 2017;3(2):95-100.
• Hussin EOD, Wong LP, Chong MC, Subramanian P. Factors associated with nurses' perceptions about quality of end-of-life care. Int Nurs Rev. 2018;65(2):200-8.
• Zumstein-Shaha M, Ferrell B, Economou D. Nurses’ response to spiritual needs of cancer patients. Eur J Oncol Nurs. 2020;48:101792.
• Heath L, Egan R, Ross J, Iosua E, Walker R, MacLeod R. Preparing nurses for palliative and end of life care: A survey of New Zealand nursing schools. Nurse Educ Today. 2021;100:104822.
• Yıldırım D, Akman Ö, Sarıkaya A. The Effect of COVID-19 Pandemic on Death Anxiety of Nursing Students. Psychiatria Danubina. 2021;33(Suppl 13):399-404.
• Alshammari F, Sim J, Lapkin S, Stephens M. Registered nurses' knowledge, attitudes and beliefs about end-of-life care in non-specialist palliative care settings: A mixed studies review. Nurse Educ Pract. 2022;59:103294.
• Wang W, Wu C, Bai D, Chen H, Cai M, Gao J, Hou C. A meta-analysis of nursing students' knowledge and attitudes about end-of-life care. Nurse Educ Today. 2022;119:105570.
• Gurdogan EP, Kınıcı E, Aksoy B. The relationship between death anxiety and attitudes toward the care of dying patient in nursing students. Psychol Health Med. 2019;24(7):843-52.
• Ek K, Westin L, Prahl C, Osterlind J, S. Strang, I. Bergh ea. Death and caring for dying patients: exploring first-year nursing students' descriptive experiences, . Int J Palliat Nurs 2014;20 (10):509–15.
• Jeffers S, Lippe MP, Justice A, Ferry D, Borowik K, Connelly C. Nursing Student Perceptions of End-of-Life Communication Competence: A Qualitative Descriptive Study. J Hosp Palliat Nurs. 2022;24(3):199-205.
• Genç Köse B. Sağlık hizmetleri meslek yüksekokulunda okuyan öğrencilerin ölüm kaygısı düzeyleri. Sürekli Tıp Eğitimi Dergisi. 2018;27(3):149-54.
• Karadağ E, Vardar İnkaya B. Hemşirelik İntörn Öğrencilerinin Ölmekte Olan Bireye Bakım Vermeye İlişkin Tutumları. Sürekli Tıp Eğitimi Dergisi. 2018;27(2):92-8.
• Hopkinson JB, Hallett CE, Luker KA. Everyday death: how do nurses cope with caring for dying people in hospital? Int J Nurs Stud. 2005;42(2):125-33.
• Mutto EM, Errázquin A, Rabhansl MM, Villar MJ. Nursing education: the experience, attitudes, and impact of caring for dying patients by undergraduate Argentinian nursing students. J Palliat Med. 2010;13(12):1445-50.
• Zhou G, Stoltzfus JC, Houldin AD, Parks SM, Swan BA. Knowledge, attitudes, and practice behaviors of oncology advanced practice nurses regarding advanced care planning for patients with cancer. Oncol Nurs Forum. 2010;37(6):E400-10.
• Banning M, Gumley VA. Clinical nurses' expressions of the emotions related to caring and coping with cancer patients in Pakistan: a qualitative study. Eur J Cancer Care (Engl). 2012;21(6):800-8.
• Adesina O, DeBellis A, Zannettino L. Third-year Australian nursing students' attitudes, experiences, knowledge, and education concerning end-of-life care. Int J Palliat Nurs. 2014;20(8):395-401.
• Grubb C, Arthur A. Student nurses' experience of and attitudes towards care of the dying: A cross-sectional study. Palliat Med. 2016;30(1):83-8.
• Frommelt KM. Frommelt attitude toward care of the dying scale. Dubuque, IA,: University of Dubuque 1988.
• Edo-Gual M, Tomás-Sábado J, Gómez-Benito J, Monforte-Royo C, Aradilla-Herrero A. Spanish Adaptation of the Frommelt Attitude Toward Care of the Dying Scale (FATCOD-S) in Nursing Undergraduates. Omega. 2018;78(2):120-42.
• Çevik B. Hemşirelerin Ölüme ve Ölmekte Olan Bireye Bakım Vermeye İlişkin Tutumları ve Deneyimleri [Yüksek Lisans Tezi]: Başkent Üniversitesi 2010
• Merlane H, Cauwood L. Core principles of end-of-life care. Br J Nurs. 2020;29(5):280-2.
• Gelegjamts D, Yong Yoo J, Kim J, Sun Kim J. Undergraduate nursing students' palliative care knowledge and attitudes towards end-of-life care: a cross-sectional descriptive study. Contemp Nurse. 2020;56(5-6):477-90.
• Laporte P, Juvet T, Desbiens JF, Tapp D, Pasquier J, Bornet MA. Factors affecting attitudes towards caring for terminally ill patients among nursing students in Switzerland: a cross-sectional study. BMJ Open. 2020;10(9):e037553.
• Abu-El-Noor NI, Abu-El-Noor MK. Attitude of Palestinian Nursing Students Toward Caring for Dying Patients: A Call for Change in Health Education Policy. J Holist Nurs. 2016;34(2):193-9.
• Arslan D, Akca NK, Simsek N, Zorba P. Student nurses' attitudes toward dying patients in central Anatolia. Int J Nurs Knowl. 2014;25(3):183-8.
• Zahran Z, Hamdan KM, Hamdan‐Mansour AM, Allari RS, Alzayyat AA, Shaheen AM. Nursing students’ attitudes towards death and caring for dying patients. Nursing Open. 2022;9(1): 614-23.
• Xu F, Huang K, Wang Y, Xu Y, Ma L, Cao Y. A Questionnaire Study on the Attitude towards Death of the Nursing Interns in Eight Teaching Hospitals in Jiangsu, China. Biomed Res Int. 2019;2019:3107692.
• Frommelt KH. Attitudes toward care of the terminally ill: an educational intervention. Am J Hosp Palliat Care. 2003;20(1):13-22.
• Cheon J, You SY. Nursing students' witnessed experience of patient death during clinical practice: A qualitative study using focus groups. Nurse Educ Today. 2022;111.
• Mastroianni C, Marchetti A, D'Angelo D, Artico M, Giannarelli D, Magna E, et al. Italian nursing students' attitudes towards care of the dying patient: A multi-center descriptive study. Nurse Educ Today. 2021;104.
• Şahin M, Demirkıran F, Adana F. Hemşirelik Öğrencilerinde Ölüm Kaygısı, Ölmekte Olan Bireye Bakım Verme İsteği ve Etkileyen Faktörler. Journal of Psychiatric Nursing/psikiyatri Hemsireleri Dernegi. 2016;7(3):135-41.
• Uysal N, Ceylan E, Koç A. Hemşirelik bölümü öğrencilerinin ölmekte olan bireyin bakımına ilişkin tutumları. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2019;8(1):98-105.
• Zheng R, Bloomer MJ, Guo Q, Lee SF. New graduate nurses' coping with death and the relationship with death self-efficacy and death anxiety: A multicentre cross-sectional study. Journal of advanced nursing. 2021;77(2):795-804.
• Nilsson S, Gibson J, Paterson C, Crookes P. Evidence informed generalist palliative care content for undergraduate nursing curriculum: An integrative review. Nurse Educ Pract. 2022;64:103447.
• Yoong SQ, Wang W, Seah ACW, Kumar N, Gan JON, Schmidt LT, et al. Nursing students' experiences with patient death and palliative and end-of-life care: A systematic review and meta-synthesis. Nurse Educ Pract. 2023;69:103625.
• Schmieding NJ. Ida Jean Orlando a Nursing Process Theory: SAGE Publications, Incorporated; 1993.
• Toney-Butler TJ, Thayer JM. Nursing Process. StatPearls. Treasure Island (FL): StatPearls Publishing, Copyright © 2022, StatPearls Publishing LLC.; 2022.