Turkiye Klinikleri Journal of Medical Ethics-Law and History

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Ölmekte Olan Hastaya Bakım: Hemşirelik Öğrencilerinin Duygu, Düşünce ve Tutumları, Bir Karma Yöntem Araştırması
Caring for Dying Patients: Feelings, Thoughts, and Attitudes of Nursing Students, A Mixed Methods Study
Zeliha ÖZDEMİR KÖKENa, Sabri KARAHANa, Atiye ERBAŞb, Çiğdem CANBOLAT SEYMANa, Sevilay ŞENOL ÇELİKc
aDepartment of Surgical Nursing, Hacettepe University Faculty of Nursing, Ankara, TURKEY
bDepartment of Surgical Nursing, Düzce University Faculty of Health Sciences, Düzce, TURKEY
cDepartment of Surgical Nursing, Koç University Faculty of Nursing, İstanbul, TURKEY
Turkiye Klinikleri J Med Ethics. 2020;28(3):365-71
doi: 10.5336/mdethic.2020-74129
Article Language: EN
Full Text
ABSTRACT
 Objective: It is thought that nursing students are not willing to participate in the complex care of dying patients. The aim of the study was to determine feelings, thoughts, and attitudes of nursing students regarding the care of dying patients. Material and Methods: A partially mixed concurrent dominant status design was used in the study. Focus group interviews were conducted to determine nursing students' feelings about and views of the care of dying patients. Five focus group interviews were conducted at the qualitative data collection stage. Frommelt Attitudes Toward Care of the Dying Scale was used to measure attitudes. Results: Four themes were identified in the qualitative data analysis: (1) feelings experienced while caring dying patients; (2) difficulties encountered while providing care to dying patients; (3) strategies of coping with the difficulties and (4) reasons for feeling incompetent in the care of dying patients. Nursing students reported they experienced intense sadness, desperation, and incompetence in the care of dying patients. The most common reasons for feeling incompetent were lack of experience, knowledge, and skill. Nursing students' mean total score on the Frommelt Attitudes Toward Care of the Dying Scale was 92.83±18.15. Conclusion: Nursing students were seen to have positive approach in the caring for dying patients, although they experienced difficulties and were often unable to cope with the situation. Nursing education curriculum for the care of dying patients should be included current training methods such as simulation and case-based learning to improve experience, confidence and competence of nursing students.

Keywords: Death; nursing care; nursing student; terminal care
ÖZET
 Amaç: Hemşirelik öğrencilerinin ölmekte olan hastaların karmaşık bakımına katılmaya istekli olmadığı düşünülmektedir. Bu çalışma hemşirelik öğrencilerinin ölmekte olan hastaya bakım konusunda duygu, düşünce ve tutumlarını belirlemek amacıyla yapılmıştır. Gereç ve Yöntemler: Çalışmada kısmen karma eşzamanlı baskın statülü tasarım karma araştırma yöntemi kullanılmıştır. Hemşirelik öğrencilerinin ölmekte olan hastanın bakımına yönelik duygu ve düşünceleri odak grup görüşmeleri ile elde edilmiştir. Nitel verilerin toplanmasında beş odak grup görüşmesi gerçekleştirilmiştir. Tutumları belirlemek için Frommelt Ölmekte Olan Bireye Bakım Vermeye İlişkin Tutum Ölçeği kullanılmıştır. Bulgular: Çalışmada nitel verilerin analizi aşamasında dört tema belirlenmiştir: (1) ölmekte olan hastalara bakım verirken deneyimlenen duygular; (2) ölmekte olan hastalara bakım verirken karşılaşılan güçlükler; (3) güçlüklerle başa çıkma stratejileri; (4) ölmekte olan hastaya bakım verirken yetersiz hissetme nedenleri. Hemşirelik öğrencileri, ölmekte olan hastalara bakım verirken yoğun üzüntü, çaresizlik ve yetersizlik deneyimlediklerini ifade etmiştir. Yetersizlik duygusunun en önemli nedenleri deneyim, bilgi ve beceri eksikliği olarak belirlenmiştir. Hemşirelik öğrencilerinin Frommelt Ölmekte Olan Bireye Bakım Vermeye İlişkin Tutum Ölçeği puan ortalaması 92.83±18.15'dir. Sonuç: Hemşirelik öğrencilerinin, deneyimledikleri zorluklara ve çoğu zaman bu durumla başa çıkamamalarına rağmen ölmekte olan hastaya bakım vermek konusunda olumlu bir tutum içerisinde oldukları belirlenmiştir. Hemşirelik öğrencilerinin tecrübe, kendine güven ve yeterliliğini artırmak için ölmekte olan hastaların bakımına yönelik hemşirelik eğitim müfredatında, simülasyon ve olgu temelli öğrenme gibi güncel öğretim tekniklerinin yer alması önerilir.

Anahtar Kelimeler: Ölüm; hemşirelik bakımı; hemşirelik öğrencisi; terminal dönem bakımı
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