Purpose: The purpose of this study was to investigate the correlation between ethical dilemma, end-of-life care stress and burnout of the nurses in long term care hospitals and descriptive correlations to identify factors affecting burnout.
Method: The subjects of study were 143 nurses who are working in the seven long-term-care hospitals in Gyeongsangnam-do. The necessity, purpose, and benefits of this study, data collection methods, time required, and confidentiality were notified to the nurses with approval of Bioethics Committee of G University in J city. As for the tool to measure ethical dilemma, ethical dilemma tool developed by Han Seong Sook(1992) was used after being modified and supplemented to be suitable for this study. End-of-life care stress was measured using the tool developed by Lee Yeon Ok(2004). As for the tool to measure burnout, the tool developed by Pines et al. (1982) was used after being translated, modified, and supplemented by Peek Eun Hee(1983). The data were analyzed with SPSS WIN/24.0 program.
Result: Ethical dilemma was 2.22±.38points(range 1?4), end-of-life care stress was 3.57±.56points(range 1?5), and burnout was 2.72±.58points (range 1?5). Ethical dilemma according to general characteristics showed statistically significant differences for existence of end-of-life care guidelines(t=-2.44, p=0.16). End-of-life care stress according to general characteristics showed statistically significant differences for existence of end-of-life care guidelines(t=-2.27, p=0.25) and satisfaction level of end-of-life care environment(t=-2.06, p=0.41). Burnout according to general characteristics showed statistically significant differences for age(F=6.48, p<.001), marital status(t=3.30, p=.001), total clinic career (F=4.65, p=.002), long term care hospital career(F=4.34, p=.006), end-of-life nursing education(t=-3.14, p=.002), and satisfaction level in end-of-life care environment(t=2.00, p=.047), Ethical dilemma and burnout had a positive correlation(r=.22, p=.008), end-of-life care stress and burnout a positive correlation(r=.16, p=.047), ethical dilemma and end-of-life care stress, a positive correlation(r=.47, p<.001). The factors effecting on burnout were age(β=-.30, p<.001), job position(β=.19, p=.016), existence of end-of-life care nursing education(β=.18, p=.017), end-of-life care stress(β=.16, p=.032). The explanatory power of influential factors was 21.9%.
Conclusion: In this study, it was founded that end-of-life care stress, age, job position, and end-of-life care education were found to be influential factors affecting burnout of the nurses in long-term care hospitals. Therefore, an improvement of end-of-life care environment to reduce end-of-life care stress and systematic intervention programs for stress management with education related to end-of-life care will be needed to prevent and relieve burnout.