일개 종합병원의 가정간호 내용과 종결상태 및 만족도 조사

Abstract

[한글]본 연구는 일개 3차 의료기관에서 가정전문간호사가 제공한 가정간호 내용과 만족도를 분석함으로써 보다 효율적인 가정간호 사업과 질적향상을 모색하기 위한 기초자료를 마련하기 위해 시도하였다본 연구는 서술적 조사 연구로서, 서울 소재 일개 3차 의료기관인 C대학 부속병원 가정간호 사업소에서 4회 이상 가정간호를 이용하고 종결한 환자 119명을 대상으로 하였다. 자료수집은 2006년 4월 3일부터 5월 12일까지 40일간 질문지를 이용한 면접방식으로 이루어졌다.연구도구는 대상자의 일반적특성 10문항, 질병관련 특성 7문항, 가정간호 이용 특성 7문항, 신체상태 평가도구 12문항, 가정간호 만족도 10문항, 행위별 만족도 1문항으로 총 47문항으로 구성되어 있다. 수집된 자료는 SPSS Win 11.5 프로그램을 이용하여 빈도분석, 기술통계 및 독립표본 t-test, one-way ANOVA로 분석하였다.연구의 결과를 요약하면 다음과 같다.1. 연구대상자 119명의 성별은 남자 49.6%, 여자 50.4%였으며, 평균연령은 62.4세 였다. 교육정도는 전문대이상이 37.0%로 가장 많았으며, 직업은 주부를 포함한 무직이 78.1%로 가장 많았다. 경제 상태는 중이 64.7%였고, 배우자가 있는 대상자가 73.1%였다. 대상자의 현 가족구성원으로는 배우자와 자녀로 구성된 대상자가 49.6%로 가장 많았고, 주 보호자는 배우자가 51.3%였다. 95.0%가 의료보험 대상자였으며, 종교는 가톨릭이 35.3%로 가장 많았다. 질환별로는 악성종양이 47.9%로 가장 많았고, 35.3%의 대상자에서 동반질환을 가지고 있었다. 의식상태는 명료가 87.4%였고, 대상자의 58.8%에서 독립적인 일상생활이 가능했다. 수술 후 의뢰된 대상자가 50.4%였고 의뢰 당시 욕창을 가지고 있는 대상자가 24.4%였다. 가정간호 의뢰 경로는 입원이 77.3%였고, 가정간호 제공기간은 평균 4.0개월로 1개월 이내가 40.3%로 가장 많았다. 가정간호 총 방문횟수는 평균 16.2회였고, 5회 이상 9회 이하가 37.8%로 가장 많았으며, 월 방문 횟수는 8회 이상이 73.9%였다. 가정간호 소요 시간은 평균 36.2분이었고, 30분 이상 59분 이하가 73.1%로 가장 많았다.2. 전체 가정간호 영역 중 교육 및 훈련이 88.2%로 가장 많은 환자에게 제공되었고, 의뢰가 5.9%로 가장 적었다.3. 종결 사유는 호전이 60.5%로 가장 많았고, 가정간호 등록시 신체상태는 가정간호 대상자인 Level Ⅱ가 88.2%로 가장 많았다. 등록 시 가정간호 대상자로 분류된 Level Ⅱ의 대상자 중 종결시 문제가 해결되어 Level Ⅰ으로 사정된 대상자가 70.0%로 가장 많았고, 등록시 입원대상자로 분류된 Level Ⅲ의 대상자중 사망으로 종결된 대상자가 75.0%로 가장 많았다.4. 전체적인 대상자들의 가정간호 이용에 대한 만족도는 4점 만점에 3.33점으로 비교적 높았으며, 가장 점수가 높은 항목은 ‘의사소통의 충분성’으로 3.59점이었고, 가장 점수가 낮은 항목은 ‘주 보호자의 편리성’으로 3.01점이었다. 제공된 간호 행위별 만족도는 4점 만점에 평균 3.38점이었으며, 10명 이상이 제공 받은 행위에서 상처소독(단순드레싱)이 3.61점으로 가장 점수가 높았고, 교육 및 훈련이 3.31점으로 가장 점수가 낮았다.5. 대상자의 일반적 특성이나 가정간호 이용 특성에 따른 만족도의 차이는 없었고, 대상자의 질병관련 특성 중 수술 후 의뢰된 대상자(t=.784, p=.040), 동반질환을 가지고 있는 대상자(t=.980, p=.012)에서 그렇지 않은 대상자에 비해 만족도가 유의하게 높았다.이상의 결과에서 교육 및 훈련 영역이 가정간호 대상자에게 가장 많이 제공되었음에도 불구하고 4점 만점에 3.31점으로 만족도가 가장 낮은 것으로 나타나 가정간호 대상자의 질환별 교육 요구도 사정에 따른 교육프로그램의 개발이 제안된다.

[영문]This study aims to offer basic information to improve home health care nursing business efficiency and its qualification improvement through analyzing contents and satisfaction rate on home health care nursing which was done with the help of home health care nursing specialized nurses in the 3rd medical institution.This study is a descriptive research done with 119 participants who have experiences of using home health care nursing service more than 4 times in the home health care nursing section of C university hospital, the 3rd medical institution located in Seoul. Data gathering was done by individual interviews with questionnaires for 40days from 3rd of April to 12th of May in 2006.Questionnaire consist of total 47 inquiries; 10 questions about general characteristics, 7 questions about disease related characteristics, 7 questions of home health care nursing use characteristics, 12 questions about health condition evaluation, 10 questions about satisfaction rate for home health care nursing, 1 question about satisfaction rate by actions. Collected data has been analyzed with the methods of frequency analysis, descriptive statistics, Independent sample t-test, one-way ANOVA using SPSS Win 11.5 program.The results of the study are as bellows.1. Of 119 questioned, male participants’ percentage was 49.6 % and female was 50.4%, and the average age of questioned was 62.4 years old. Regarding the level of education, above technical collage graduation took the highest percentage of 37.0%, and about occupation, inoccupation was the highest of 78.1%. In terms of financial status, middle class was 64.7%, and the percentage of questioned with a partner was 49.6%. Concerning family composition, the percentage of questioned with a partner and children marked the highest of 49.6%. In addition, as a main supporter, the percentage of a partner was 51.3%. 95% of questioned was medical insurance covered, and as for religion, Catholic took the highest of 35.3%. By disease, malignancy tumor was 47.9%, and 35.3% of questioned had other related disease at the same time. In terms of consciousness status, status of being clear was 87.4% and 58.8% of the questioned could be able to have an independent normal life. Participants w! ho were requested after surgery was 50.4% and 24.4% of the requested had a bedsore at that time. The most answered reason for home health care nursing was via hospitalization which was 77.3%, and the average period of home health care nursing was 4.0 months and within 1 month of duration was answered the highest percentage of 40.3%. Total visit numbers of home health care nursing was 16.2 times on average, and more than 5 times less than 9 times was 37.8%. In terms of the average monthly visit frequency, more than 8 times was 73.9%. Consuming time for home health care nursing was 36.2 minutes on average, and more than 30 minutes less than 59 minutes was 73.1%.2. In the whole section of home health care nursing, education and training were offered to patients the most of 88.2%, and request was the lowest of 5.9%.3. As ending reason, being recovered was 60.5%, and as for physical condition when registering a home health care nursing, Level II was 88.2%. Out of Level II, 70.0% of the participants were turned into Level I since their problems were solved in the end, and among Level III who has been categorized as hospitalization, 75.0% of them was ended as death.4. Satisfaction rate of the questioned marked 3.33 out of 4 scale that was relatively high.The highest scored item was ‘sufficiency of communication (3.59) and the lowest scored item was ‘main supporter’s convenience (3.01). Satisfaction rate by nursing actions marked 3.38 out of 4 scale, and wound disinfection (simple dressing) marked the highest percentage of 3.61 and, on the other hand, education and training marked the lowest percentage of 3.31.5. There was no difference according to general characteristics of the questioned and home health care nursing use characteristics. In terms of subjects’ disease, the ones who were requested after surgery (t=. 784, p=. 040) and the ones with other diseases (t=. 980, p=. 012) showed higher satisfaction rate.We could see that the section of education and training marked the lowest, 3.31 out of 4 scale even though those sections were offered to home health care nursing subjects. Therefore, it is suggested to develop an education program according to education request rate by diseases.