가족발달단계에 따른 간호요구영역에 관한 연구

Abstract

[한글]

지역사회 건강사업에서는 가족이 사업단위이며 건강사업의 초점은 한 개인보다는 한 가 족의 건강문제와 간호요구에 있다.

지역사회 간호원은, 가족의 건강유지 증진이라는 지역사회간호의 개념에서 볼때, 가족 의 상장과 발달에 대한 지식을 가져야 하며 정상적인 가족발달을 위한 포괄적인 격려를 하는데에 그 책임이 있다. 따라서 지역사회 간호원은 가족의 발달에 따른 간 호요구와 문

제해결능력을 파악하므로서 간호계획을 세우고 주어진 사업을 평가하는데 도움을 줄 수 있다.

가족발달단계별로 간호요구영역을 알아보기 위해 다음과 같은 목적을 설정하였다.

1. 가족발달단계별 조사기구의 일반적 특성파악

2. 간호요구영역별 가족발달단계에 따른 문제발생 및 간호요구도와 해결능력도 파악

3. 가족발달단계별 간호요구영역전체에서의 문제발생 및 간호요구도와 해결능력도 파악

가족발달단계는 Duvall이 분류한 8단계를 인용하였다.

1단계 : 결혼한 부부 (자녀가 없음)

2단계 : 출산기 가족 (첫자녀가 생후 30개월 이내)

3단계 : 학령전기 아동이 있는 가족 (첫자녀가 생후 30개월∼6년 사이)

4단계 : 학령기 아동이 있는 가족 (첫자녀가 6∼13세 사이)

5단계 : 십대 (十代)의 자녀가 있는 가족 (첫자녀가 13∼20세)

6단계 : 출타 (出他)한 자녀가 있는 가족 (첫자녀가 군대, 결혼, 학업, 직장등으로 동

거하지 않고 막내는 아직 가정에 남아 있는 가족)

7단계 : 장년기의 가족 (막내자녀까지 모두 출타하여 부부만 남음)

8단계 : 은퇴기의 가족 (부부중 한 배우자가 사망하였거나 둘 모두 사망할때까지)

연구자료는 연세대학교 간호학연구소와 인구 및 가족계획 연구소에서 1974년 7월에 경기도 강화군에서 조사한바 있는 「건강 및 간호요구와 사회제도에 관한 소지역 종합연구」를 위한 자료 중에서 본 연구의 목적에 필요한 간호요구영역만을 이용하였다.

연구대상가구로는 핵가족 260가구만을 표본 선정하였다.

연구결과의 통계적 분석방법은 백분율 평균치의 F-test를 이용하였다.

연구결과 요약하면 다음과 같다.

1. 가족발달단계별 연구대상가구의 일반적 특성

1) 전 대상가구중 발달단계별 가구수는 1단계가 3지구, 2단계가 13지구, 3단계가 24지구, 4단계가 41가구, 5단계가 50가구, 6단계가 106가구, 7단계가 13지구, 8단계가 10가구이다.

2) 가족크기는 1단계, 7단계, 8단계를 제외하고는 약 4∼5명이다.

3) 부모의 현재연령은 단계가 높아질수록 높고, 결혼연령은 단계가 높아질수록 낮다.

4) 부모의 교육수준은 발달단계별 구분없이 국졸이하가 대부분이다.

5) 부모의 직업은 발달단계별 구분없이 노동직이 반수이상이다.

6) 부모의 종교는 발달단계별 구분없이 반수이상이 종교를 갖지 않았다.

7) 자녀의 연령은 2단계에서 6단계 사이에는 단계가 높아질수록 분포의 범위가 넓다.

8) 가구의 경제수준은 발달단계별 구분없이 중층, 하층 수준이 반수이상이다.

2. 가족발달단계별 간호요구영역에서의 문제발생 및 간호요구도와 해결능력도

1) 각 발달단계별로 문제가 발생한 영역을 알아본 결과는 가옥과 위생, 식습관, 기사운영, 예방적관리, 치아관리는 발달단계별 구분없이 전체적으로 문제가 많이 발생했으며, 이외에 1단계는 사고 예방, 2단계는 예방접종과 가족계획, 3단계는 예방접종, 모성보건,

가족계획, 유아 및 학령전 아동보건, 4단계와 5단계는 예방접종, 가족계획, 학령기 아동보건, 6단계는 예방접종과 학령기 아동보건의 영역에서 문제가 많이 발생했다.

2) 각 발달단계별 간호요구영역에서의 간호요구도를 알아본 결과는 급만성질환 1단계를 제외하고는 발달단계별 구분없이 전체적으로 간호요구도가 중등도 이상이다. 이외에 1단계는 모성보건, 3단계는 가옥과 위생, 사고예방, 4단계는 가옥과 위생, 5단계는 가옥과

위생, 진단 및 의료, 6단계는 진단 및 의료, 7단계는 진단 및 의료, 가사운영, 8단계는 가옥과 위생, 사고예방, 진단 및 의료, 차아관리, 식습관, 가사운영의 영역에서 중등도 이상의 간호요구를 가졌다.

3) 각 발달단계별로 간호요구영역에서의 해결능력도를 알아본 결과는 1단계는 진단 및 의료, 모성보건, 2단계는 사고예방, 급만성질환, 치아관리, 3단계는 가옥과 위생, 급만성질환, 진단 및 의료, 예방적관리, 치아관리, 모성보건, 유아 및 학령전 아동보건, 식습관의 영역에서 5단계는 가옥과 위생, 사고예방, 급만성질환, 진단 및 의료, 예방적관리, 치아관리, 예방접종, 모성보건, 식습관의 영역에서 중등도이하의 해결능력을 가졌다. 7단계와 8단계는 문제가 발생하지 않았던 영역을 제외한 9개 영역 즉 가옥과 위생, 사고예방,

급만성질환,진단 및 의료, 예방적관리, 치아관리, 예방접종, 식습관, 가사운영의 영역에서 중등도 이하의 해결능력을 가졌다.

3. 가족발달단계별 간호요구영역전체에서의 문제발생 및 간호요구도와 해결능력도를 알아본 결과는

1) 문제발생은 1단계를 제외하고는 단계가 높아질수록 낮아졌고

2) 간호요구도는 단계가 높아질수록 낮아졌으며

3) 해결능력도는 7단계와 8단계를 제외하고는 단계가 높아질수록 높아졌다.

결론적으로 발달단계별로 가족의 간호계획을 세울때는 문제발생이 높고 중등이상의 간호요구와 중등도 이하의 해결능력을 가진 간호요구영역에서, 그리고 발달단계가 높은 가족보다는 낮은 가족에게, 그리고 간호요구도에 비해 해결능력도가 낮은 7단계와 8단계에 간호사업의 우선순위를 두어야 한다.

Study of The Area of Nursing Need by the Family Developmental Stage

Choi, Boo Ok

Department of Nursing Graduate School of Yonsei University

(Directed by Professor Hong, Shin Young)

The Community Health Service considers the family as a service unit and places

the emphasis of its service on the health problems and the nursing needs of the

family rather than the individual.

From the conceptual point of view that the community health service is both

health maintenance and health promotion, of the family, the community health nurse

should have a knowledge of the growth and development of the family and be

responsible for the comprehensive support of normal family development. The

communtity health nurse often is in a position to make a real contribution to

normal family development.

In order to investigate the relationship between the areas of nursing need and

family need and family development, the following objectives were established.

1. To discover the general characteristics of the study population by the stage

of family development.

2. To discover specific nursing needs in relation to the family developmental

stage, and to determine the intensity of the nursing needs and the ability of the

family to cope with these needs.

3. To discover overall family health nursing problems in relation to the family

developmenal stage and determine the intensity of the nursing need and the problem

solving ability of the family.

Definitions

The family developmental stage as classified by Duvall were used.

stage 1. Narried couples (without children)

stage 2. Childbearing Families (oldest chily birth to 30 months of age)

stage 3. Families with preschool children (oldest child 2½ to 6 years)

stage 4. Families with schoolchildren (oldest child 6 to 13 years)

stage 5. Families with teenagers (oldest child 13 to 20 years)

stage 6. Families as launching centers (first child gone to last child's leaving

home)

stage 7. Middle-aged parents (empty nest to retirement)

stage 8. Aging family members (retirement to death of both spouses)

The areas of nuring need were defined as those used in the study, "A

Comprehensive Study", by the Nursing Research Institute and Center for Population

and Family Planning, July 1974.

The study population defined and selected were 260 nuclear family in two myun of

Kang Hwa Island.

Percent, mean value and F-test were utilized in the statistical analysis of the

study results.

Findings :

A. General characteristics of the study population by the family developmental

stage

1) The study population was distributed by the family developmental stage as

follows :

stage 1 : 3 families

stage 2 : 13 families

stage 3 : 24 families

stage 4 : 41 families

stage 5 : 50 families

stage 6 : 106 families

stage 7 : 13 families

stage 8 : 10 families

2) Most families had 4 or 5 members except for those in stages 1, 7, and 8.

3) The parents' present age was older in the higher developmental stages and

their age at marriage was also younger in the higher developmental stages.

4) The educational level of parents was primarily less than elementary school

irrespective of the developmental stages.

5) More than half of the parents' occupations were listed as lahorers

irrespective of the developmental stages.

6) More than half of the parents were athiests irrespective of the developmental

stages.

7) The higher the developmental stages (from stage 2 to stage 6), the wider the

distribution of children's ages.

8) More than half of the families were of midde or lower socio-economic level.

B. Problems in specific areas of family developmental stage, the inbensity of

nursing need and the problem solving ability of the family :

1) As whole, many problems, irrespective of the developmental stage, occurred in

the areas of Housing and Sanitation, Eating Patterns, Housekeeping, Preventive

Measures and Dental care. Problems occurring in particular stage included the

following :

stage 1 : Prevention of Accident

Stage 2 : Preventive Vaccination, Family Planning.

Stage 3 : Preventive Vaccination, Maternal Health, Family Planning, Health of

Infant and Preschooler.

Stage 2 : Preventive Vaccination, Family Planning, Health of School Children.

2) The intensity of the nursing need in the area of Acute and Chronic Diseases

was generally of moderate degree or above irrespective of moderate degree or adove

irrespective of developmental stage except for stage 1.

Other areas of need listed as moderate or above were found in the following

stage 1 : Maternal Health

stage 3 : Housing and Sanitation, Prevention of Accident.

stage 4 : Housing and Sanitation

stage 5 : Housing and Sanitation, Diagnostic and Medical Care

stage 6 : Diagnostic and Medical care

stage 7 : Diagnostic and Medical Care, Housekeeping.

stage 8 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical

care Eating Patterns, Housekeeping.

3) Areas of need with moderate problem solving ability or less were as follows :

stage 1 : Diagnostic and Medical Care, Maternal Health.

stage 2 : Prevention of Accident, Acute and Chronic Dioease, Dental Care.

stage 3 : Housing and Sanitation, Acute and Chronic Dioease, Diagnostic and

Medical care, Preventive Measure, Dental Care, Maternal Health, Health of Infant

and Preschooler, Eating Patterns.

stage 4 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical

Care, Preventive Measure, Dental Care, Maternal Health, Health of New Born, Health

of Infant and Preschooler, Health of school Children, Eating Patterns,

Housekeeping.

stage 5 : Housing and Sanitation, Prevention of Accident, Acute and Chronic

Dioease, Diagnostic and Medical care, Preventive Measure, Dental Care, Preventive

Vaccination, Maternal Health, Eating Patterns.

stage 7,8 : Housing and Sanitation, Prevention of Accident, Acute and Chronic

Dioease, Diagnostic and Medical care, Preventive Measure, Dental Care, Preventive

Vaccination, Eating Patterns, Housekeeping.

C. Problem occurance, the degree of nuring need and the dergree of problem

solving ability in nursing need areas for the family as a whole were as follows :

1) The higher the stage (except stage 1), the lower the rate of problem

occurance.

2) The higher the stage becomes, the lower the intensity of the nursing need

becomes.

3) The higher the stage (except stage 7 and 8), the higher the problem solving

ability.

Conclusions ;

1) When the nuring care plan for the family is drawn up, depending upon the stage

of family development, higher priority should be give to the nursing need areas ①

at which problems were shown moderate degree and ② where the nursing need is shown

to be adove moderate dergee and ③ where the problem solving ability was shown to

be of moderate degree.

2) The priority of the nursing service should be placed ① not on those families

in the high developmental stage but on those family in the low developmental stage

② and on those areas of need shown in stage 7 and 8 where the dergee of nursing

need was high and the ability to cope low.

[영문]

The Community Health Service considers the family as a service unit and places the emphasis of its service on the health problems and the nursing needs of the family rather than the individual.

From the conceptual point of view that the community health service is both health maintenance and health promotion, of the family, the community health nurse should have a knowledge of the growth and development of the family and be responsible for the comprehensive support of normal family development. The

communtity health nurse often is in a position to make a real contribution to normal family development.

In order to investigate the relationship between the areas of nursing need and family need and family development, the following objectives were established.

1. To discover the general characteristics of the study population by the stage of family development.

2. To discover specific nursing needs in relation to the family developmental stage, and to determine the intensity of the nursing needs and the ability of the family to cope with these needs.

3. To discover overall family health nursing problems in relation to the family developmenal stage and determine the intensity of the nursing need and the problem solving ability of the family.

Definitions

The family developmental stage as classified by Duvall were used.

stage 1. Narried couples (without children)

stage 2. Childbearing Families (oldest chily birth to 30 months of age)

stage 3. Families with preschool children (oldest child 2½ to 6 years)

stage 4. Families with schoolchildren (oldest child 6 to 13 years)

stage 5. Families with teenagers (oldest child 13 to 20 years)

stage 6. Families as launching centers (first child gone to last child's leaving home)

stage 7. Middle-aged parents (empty nest to retirement)

stage 8. Aging family members (retirement to death of both spouses)

The areas of nuring need were defined as those used in the study, "A Comprehensive Study", by the Nursing Research Institute and Center for Population and Family Planning, July 1974.

The study population defined and selected were 260 nuclear family in two myun of Kang Hwa Island.

Percent, mean value and F-test were utilized in the statistical analysis of the study results.

Findings :

A. General characteristics of the study population by the family developmental stage

1) The study population was distributed by the family developmental stage as follows :

stage 1 : 3 families

stage 2 : 13 families

stage 3 : 24 families

stage 4 : 41 families

stage 5 : 50 families

stage 6 : 106 families

stage 7 : 13 families

stage 8 : 10 families

2) Most families had 4 or 5 members except for those in stages 1, 7, and 8.

3) The parents' present age was older in the higher developmental stages and their age at marriage was also younger in the higher developmental stages.

4) The educational level of parents was primarily less than elementary school irrespective of the developmental stages.

5) More than half of the parents' occupations were listed as lahorers irrespective of the developmental stages.

6) More than half of the parents were athiests irrespective of the developmental stages.

7) The higher the developmental stages (from stage 2 to stage 6), the wider the distribution of children's ages.

8) More than half of the families were of midde or lower socio-economic level.

B. Problems in specific areas of family developmental stage, the inbensity of nursing need and the problem solving ability of the family :

1) As whole, many problems, irrespective of the developmental stage, occurred in the areas of Housing and Sanitation, Eating Patterns, Housekeeping, Preventive Measures and Dental care. Problems occurring in particular stage included the following :

stage 1 : Prevention of Accident

Stage 2 : Preventive Vaccination, Family Planning.

Stage 3 : Preventive Vaccination, Maternal Health, Family Planning, Health of Infant and Preschooler.

Stage 2 : Preventive Vaccination, Family Planning, Health of School Children.

2) The intensity of the nursing need in the area of Acute and Chronic Diseases was generally of moderate degree or above irrespective of moderate degree or adove irrespective of developmental stage except for stage 1.

Other areas of need listed as moderate or above were found in the following

stage 1 : Maternal Health

stage 3 : Housing and Sanitation, Prevention of Accident.

stage 4 : Housing and Sanitation

stage 5 : Housing and Sanitation, Diagnostic and Medical Care

stage 6 : Diagnostic and Medical care

stage 7 : Diagnostic and Medical Care, Housekeeping.

stage 8 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical care Eating Patterns, Housekeeping.

3) Areas of need with moderate problem solving ability or less were as follows :

stage 1 : Diagnostic and Medical Care, Maternal Health.

stage 2 : Prevention of Accident, Acute and Chronic Dioease, Dental Care.

stage 3 : Housing and Sanitation, Acute and Chronic Dioease, Diagnostic and Medical care, Preventive Measure, Dental Care, Maternal Health, Health of Infant and Preschooler, Eating Patterns.

stage 4 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of New Born, Health of Infant and Preschooler, Health of school Children, Eating Patterns,

Housekeeping.

stage 5 : Housing and Sanitation, Prevention of Accident, Acute and Chronic Dioease, Diagnostic and Medical care, Preventive Measure, Dental Care, Preventive Vaccination, Maternal Health, Eating Patterns.

stage 7,8 : Housing and Sanitation, Prevention of Accident, Acute and Chronic Dioease, Diagnostic and Medical care, Preventive Measure, Dental Care, Preventive Vaccination, Eating Patterns, Housekeeping.

C. Problem occurance, the degree of nuring need and the dergree of problem solving ability in nursing need areas for the family as a whole were as follows :

1) The higher the stage (except stage 1), the lower the rate of problem occurance.

2) The higher the stage becomes, the lower the intensity of the nursing need becomes.

3) The higher the stage (except stage 7 and 8), the higher the problem solving ability.

Conclusions ;

1) When the nuring care plan for the family is drawn up, depending upon the stage of family development, higher priority should be give to the nursing need areas ① at which problems were shown moderate degree and ② where the nursing need is shown

to be adove moderate dergee and ③ where the problem solving ability was shown to be of moderate degree.

2) The priority of the nursing service should be placed ① not on those families in the high developmental stage but on those family in the low developmental stage ② and on those areas of need shown in stage 7 and 8 where the dergee of nursing need was high and the ability to cope low.